Following stoma creation, the rate of early and late ostomy complications increases with time. The management of these complications requires consistent treatment, which in most cases initially requires only non-operative measures if stoma reversal is planned. In the case of refractory stoma complications, therefore, the possibility of early reversal as an alternative to surgical complication management should always be considered. Hand-sewn anastomosis versus stapler ileo-ileostomy for ileostomy closure are equivalent in terms of morbidity. Prerequisites for stoma reversal include evidence of completed healing of the downstream anastomosis by endoscopy and radiological imaging, as well as recovery of the patient. In primarily healed anastomosis, reversal usually takes place 10–12 weeks after creation. Adjuvant chemotherapy is one of the main reasons for doubling the duration of ostomy. Earlier reversal of a loop ileostomy seems to be feasible in individual cases with comparable morbidity and mortality. There are no clear recommendations or guidelines for the timing of stoma reversal, neither for loop ileostomy nor end colostomy. The reversal of a Hartmann’s procedure is usually performed 6 months after primary surgery, depending on the underlying disease and recovery of the patient. When performed by an appropriately experienced operator, the laparoscopic approach is a safe alternative to open surgery. Skin closure should be performed by either linear skin closure or circumferential purse-string approximation, which is associated with a lower rate of septic complications compared to the linear suture.