Childhood colostomy is often indicated for obstructive congenital lesions of the colon and anorectum as well as a few acquired ones. In a prospective 3-year study of 66 childhood colostomies performed at the Lagos University Teaching Hospital, 33 (50%) were fashioned for Hirschsprung's disease while 28 (42.50%) stomas were fashioned for anorectal anomalies. Eighty complications were recorded in 27 (40.9%) of the 66 colostomies. There were 13 (19.7%) early complications comprising of 3 (4.5%) cases each of hemorrhage and septicaemia and 2 (3%) each of colostomy retraction, non-function and stoma1 necrosis. One patient developed necrotising fasciitis. Skin excoriation was the commonest complication, and was seen in 22 (33.3%) of the patients. Colostomy diarrhoea occurred in 20 patients and was responsible for almost all the excoriations. Prolapse was seen in 12 (18.2%) colostomies. Failure to thrive accompanying frequent colostomy diarrhoeas was seen in 8 (12%). One case each of parastomal fistula was recorded. Of the 54 colostomies closed by the end of the study period, 10 (18.5%) developed complications. Wound infection was observed in 4 (7%) and intestinal obstruction was seen in 3 (5.5%). Two of the latter were from stenosis at the closed colostomy site while one resulted from adhesive bowel obstruction. Faecal fistula developed in 2 (3.7%) other cases while one case of incisional hernia was recorded. Although 4 (6%) of the children died within the study period, only one (1.5%) was attributable to the colostomy. The presence of a colostomy is associated with significant morbidity in children. To minimize these problems, the paediatric surgeon must pay close attention to the fashioning, management and closure of a colostomy. The dearth of stoma care nurses for home visits and supervision of stoma care remains a big challenge in our setting.