PURPOSE: Laparoscopic sigmoid colectomy (LSC) is frequently performed for sigmoid diseases with excellent prognosis. We aimed to determine the long-term quality-of-life after open sigmoid colectomy (OSC) compared with LSC. METHODS: Thirty-nine patients were investigated 40.5+/-2.8 months (mean+/-SEM) after LSC. Each LSC patient was matched to a patient after OSC. Patients were interviewed by telephone and the Eypasch quality-of-life questionnaire was answered by mail. RESULTS: LSC entailed fewer minor complications (P=0.0003) and 97% of the patients were satisfied with the cosmetic result, which was more compared with 63% after OSC (P=0.001). Patients suffering from recurrent diverticulitis had a similar quality-of-life index after LSC and OSC (P=0.945). A minor trend was observed in patients with early-staged colorectal neoplasia in favor of LSC (113.6+/-3.3 vs. 106.0+/-4.2; P=0.21, mean+/-SEM). CONCLUSIONS: LSC is superior concerning minor complications and cosmesis, whereas quality-of-life is similar in the long term.