The purpose of the study was to prospectively describe ostomy configuration and evaluate ostomy related complications and association to possible risk factors. Method All elective patients (n=180) operated with a colostomy, ileostomy or loop-ileostomy formated between 2003 and 2005 were included in the study. The follow-up took place at ward postoperatively and five times during two year after discharge. At these occasions diameter and height of the ostomy were recorded. Complications such as, peristomal skin problems, necrosis, leakage due to low ostomy, stenosis, granuloma, prolaps and peristomal hernia was evaluated. Results Most complications occurred two weeks after discharge; 53% of patients with colostomies, 79% with loop-ileostomies and 70% of patients with ileostomy had one or more complications. The most common complication was skin problem and was most common in patients with ileostomies (60%) and loop-ileostomies (73%). Postoperative at ward, the most common complication was necrosis, which occurred in 20% of patients with a colostomy. Granuloma was most frequent in colostomies. Almost all patients with an ileostomy and loop-ileostomy with a height lower than 20 mm had leakage and skin problems and half of patients with a colostomy height lower than 5 mm. Conclusion To prevent ostomy related complications it is important with an adequate height of the ostomy, early and regular follow-ups with adjustment of the appliance. To work closely in collaboration with the colorectal surgeons is of utmost important to provide feedback and by that improve ostomy outcome.