A crucial and often debated aspect in management of anorectal malformation (ARM) relates to surgical repair: who should perform the procedure? However, this question alone does not encapsulate the totality of care required for patients with ARM. As we have learned over time, care for patients with ARM typically necessitates a multidisciplinary team for evaluation, surgical management, and long-term care due to the frequent co-occurrence of additional medical diagnoses and to achieve best long term outcomes. Establishing and gaining access to this specialized multidisciplinary care presents substantial challenges. This chapter will review the contemporary status of pediatric colorectal ARM surgery, pinpoint obstacles to specialized care, outline the essential facets of multidisciplinary care for colorectal patients, and define best practices. The importance of long-term follow-up, including renal monitoring and bowel management, will also be reviewed. The proposed evaluation metrics included encompass quality of life, surgical outcomes, adherence to care bundles, cost-effectiveness, and patient satisfaction, and aim to establish universal meaningful outcomes for future research and help define high-quality pediatric colorectal specialty centers.