Continent urinary diversion has evolved from an investigational method of urinary tract reconstruction to an accepted, and in many instances preferred, option for men and women facing radical cystectomy. Over the last 15 years, we have learned much about the different procedures, their durability, and their success rates. This article reports on the procedures that the authors believe are associated with the highest success rates and the lowest complication rates. At this time, continent diversion should be offered to all appropriate candidates, and these procedures should be considered a part of the standard urologic armamentarium.