Objective To assess the functional outcome and sexuality of patients after creation of a sigmoid neovagina. Design Clinical study performed between 1992 and 2002, with a mean follow-up of 3.3 years (range, 6 months to 9 years). Setting Tertiary care center. Patient(s) Sixteen consecutive patients with Rokitansky syndrome. Intervention(s) Creation of a neovagina with an antiperistaltic (n = 13) or isoperistaltic (n = 3) sigmoid graft and colovestibular anastomosis by interrupted suture (n = 11) or PCEEA forceps (n = 5). All patients had a neovaginal vault suspension (n = 16). Main outcome measure(s) Functional results were evaluated in patients 6 or more months after the operation (n = 12) by using the standardized Female Sexual Function Index (FSFI). This index assesses four domains of sexual dysfunction: desire disorder, arousal disorder, orgasm disorder, and sexual pain disorder. Lubrification and “sexual” quality of life was also evaluated. Normal patients had a mean full FSFI score of 30 ± 5 of 36. Result(s) The mean full FSFI score was 28 ± 5 (range: 22–34). Seventy-two percent of patients had vaginal intercourse at least once a week; in this subset, the mean full FSFI score was 30 ± 3 (range: 25–34). Conclusion(s) Sigmoid neovagina allowed a normal sexual life in patients who had sexual relations.