This chapter discusses various methods for creating anastomoses in different regions of the gastrointestinal tract, focusing on neck, chest, and oesophago-jejunal anastomoses. In neck anastomoses, hand-sewn techniques are favoured over staplers due to limited space. Techniques involve careful preparation of the oesophageal stump and the conduit, followed by meticulous suturing in two layers. In chest anastomoses, both stapled and hand-sewn methods are detailed, emphasising technical nuances to ensure proper alignment and integrity of the anastomosis. For oesophago-jejunal anastomoses, hand-sewn techniques are discussed, particularly in situations with limited space, with detailed steps outlined to achieve optimal outcomes. The chapter provides valuable insights into the surgical principles and techniques essential for successful anastomotic procedures in various clinical scenarios.