When the need for urinary diversion arises, whether from carcinoma of the urinary tract, malfunction, or malformation, a decision must be made about the type of diversion to be performed. Currently, the patient and surgeon must decide on continent versus noncontinent versus neobladder and on the type of intestinal segment to be used. Not long ago noncontinent diversion was the only choice available, and for many patients, it remains the best choice. It is the fastest, the simplest to perform and to care for, and is associated with the least risk of long-term and short-term complications. A noncontinent diversion is, in essence, a disarticulated bowel segment to which the ureters are attached proximally and with a stoma distally. Any segment of ureter can be accommodated, from the renal pelvis to trigone, and any segment of bowel can form the conduit, although ileum and colon are associated with the fewest metabolic consequences.