Surgical management of fecal incontinence is only considered following comprehensive multidisciplinary assessment and failure of conservative measures to achieve a quality of life acceptable to the client. It is important at the outset to realize that surgical intervention, except in the situation of surgical repair of an acute anal sphincter injury, can rarely restore perfect continence. Setting a realistic expectation of outcomes is essential and requires careful explanation of the underlying causes which are often multifactorial. This chapter explains the common surgical procedures used for treating fecal incontinence and the focused postoperative nursing care for the advanced practice continence nurse. A general knowledge of the available surgical procedures and the indications for and expected outcomes of the surgeries may assist the advanced practice continence nurse in decision-making for patient referrals, postoperative management, and support of the patient. The chapter also discusses innovative and experimental procedures for fecal incontinence currently being investigated.