Thirty-one patients in whom ureterosigmoidostomy had been performed between 1952 and 1974 for a variety of conditions are presented. Twelve patients, or 39%, were subsequently rediverted, mainly for upper tract deterioration. Nineteen patients retaining their ureterosigmoidostomy were evaluated after 3 to 22 yr. Growth was normal in all. Twelve patients required regular alkali and three intermittant antibiotics. In 14 patients, the I.V.U. remained perfect. Each patient was interviewed. Voiding was on average three hourly. Some urgency was common, but soiling was rare. Sleep was disturbed in nearly half the patients but this was usually around dawn. Lessons were rarely interrupted and nearly all took part in sports. The large majority felt no different from their peers. In spite of close initial supervision and significant rediversion rate, ureterosigmoidostomy can provide a very acceptable form of urinary diversion in children. © 1979.