Ileal conduit urinary diversion is commonly performed after extirpative pelvic surgery for both benign and malignant reasons. Despite several decades of experience and many technical advancements, ileal conduits are associated with a variety of short- and long-term complications. In this chapter, we review the types of complications that may occur and special considerations for management in female patients. These complications may be related to the stoma itself (skin, hernia, stenosis), bowel reconstruction (stricture, ileus, obstruction, fistula), or urinary system (infection, metabolic disturbances). Sexual side effects, including long-term sexual function and body image, may lead to unique quality-of-life considerations as well. A multidisciplinary approach, including specialized stoma care and psychological support, is essential to manage and improve the quality of life for patients undergoing this procedure. Future research on the impact of these complications specifically in women is needed.