The use of intestine to substitute for the diseased or absent bladder represents an important surgical innovation in gastrointestinal surgery to emerge during the past century. Intestinal urinary diversions have evolved from simple conduits to true continent storage vessels that may, in some circumstances, be anastomosed to the urethra to function as a neobladder. All segments of the bowel have been utilized toward this end. It is the purpose of this chapter to outline the basic types of urinary diversions most commonly in use in North America and Europe today and to review the complications associated with them.