A simple and safe technique for examining the ileal pouch in the post-operative period is described, and the findings in 85 patients reviewed. Extravasation from the ileo-anal anastomosis was seen in 10/85 (11%). In 14/85 (16%) the lateral view of the filled pouch showed a presacral space > 4 cm, which in 10 (71%) was due to a significant abnormality: six having an anastomotic leak with presacral abscess, two a large presacral haematoma, and two an abscess without anastomotic leak. Pouchography is recommended as a routine examination prior to closure of the covering ileostomy.