To estimate the cumulative incidence of colectomy for ulcerative colitis (UC) patients in the UK, and the risk of perioperative complications and mortality. A literature review was conducted using Medline. Search keywords included UC, terms for surgical interventions such as colectomy, proctocolectomy, ileal pouch anal anastomosis, ileoanal pouch, pouch surgery, ileorectal anastomosis, and ileostomy. Paediatric population studies were excluded. In addition, the review considered data from the UK inflammatory bowel disease (UK IBD) audits in 2012 and 2014. The Medline search identified 310 unique records. Nine studies reported data on UK patients. Five of them considered only emergency operations for the management of acute exacerbations. From the remaining four records, two publications reported data from large, population-based studies, with 15 and 20 years of patient follow-up. The evidence suggested a linear increase in the incidence after the first 5 years since diagnosis. The cumulative probability of colectomy ranged from 6.9% over 15 years in one study to 8.3% and 11.2% at 10 and 20 years since diagnosis in the second study. This cumulative risk was lower, but broadly within the range of colectomy incidence rates presented by other studies from Norway or a multi-country meta-analysis of population-based studies for surgery in inflammatory bowel diseases. The UK IBD reported complications among 32% and 35% of patients undergoing elective and non-elective surgery respectively, with wound infection being the most common event. The overall mortality was reported to be reduced by 19% between two consecutive versions of the audit: 0.92% (28/3049) in 2010-2012 and 0.75% (30/3987) in 2012-2014. Colectomy is still the last option for UC patients with an inadequate response to pharmacological treatments. The cumulative probability of colectomy, since diagnosis of UC, showed a steady increase but remained in comparable levels with other non-UK studies.