BACKGROUND Pediatric ulcerative colitis (UC) that is resistant to medical therapy is managed surgically with a colectomy and ileal pouch anal anastomosis. Family and patient concerns including quality of life (QoL), bowel function, and surgical complications may factor heavily in the decision to proceed with surgical intervention. OBJECTIVE We aim to investigate the QoL, bowel habits, and operative outcomes of younger (≤11 years old) compared with older patients with pediatric UC after surgical intervention. METHODS Medical records of patients with UC after colectomy with ileoanal reconstruction (2002–2013) at our institution were reviewed. Patients/parents completed a QoL (ranging from 0 = best to 10 = worst, assessing physical, social, and psychological aspects), bowel habit, and disease course questionnaire and then compared younger (age ≤ 11 years, n = 26) with older (age > 11 years, n = 38) patients. Data were analyzed by t test or Fisher’s exact test, expressed as mean ± SEM with significance of p ≤ .05. RESULTS The mean age at colectomy was 7.04 ± 0.63 versus 14.71 ± 0.32 years in the two groups. Follow-up (months) was similar between groups (younger: 19.03 ± 5.36 vs. older: 14.31 ± 2.65, p = .391). Questionnaire return rate was high (71%). Both age groups expressed a significant and similar improvement in QoL after surgery (6.76 ± 0.56 to 2.05 ± 0.39 in younger cohort and 7.32 ± 0.33 to 2.6 ± 0.379 in older cohort). Specific variables assessed including energy level, pain, limitations, effect on family, diet restrictions, missed school, appearance, happiness, and missed social events were all significantly improved (p < 0.001) following surgery in both the younger and older cohorts. Patients had a significant reduction in stooling frequency compared to pre-colectomy in younger (12.89 ± 1.86 to 4.61 ± 0.47, p < 0.001) and older (14.74 ± 1.91 to 5.04 ± 0.29, p < 0.001) patients. Rate of pouchitis was similar between younger (23.8%) and older (29.4%) patients, as was post-operative small bowel obstruction 19% vs 24% respectively. Dehydration was slightly increased in the younger population, 15% vs 5%. Anastomotic leak (7.7% vs 10.5%) and stricture (11.5% vs 21.1%) rates were reduced in younger patients. CONCLUSIONS A colectomy with ileoanal anastomosis for younger children (≤11 years old) with UC is without increased complications relative to older patients, even a slightly decreased anastomotic stricture and leak rate, and offers similar improvement in quality of life and stooling patterns.