Objective To analyze the clinical characteristics of small intestinal stoma closure operation and reduce the complications. Methods The clinical data of 131 patients who received small intestinal stoma closure operation were reviewed retrospectively. According to the presence or absence of previous serious abdominal infection, abdominal chemotherapy, the history of more than three times of abdominal surgery and other risk factors, patients were divided into low risk (n=96) and high risk (n=35) groups. All the patients underwent preoperative imaging examinations, including chest and abdomen enhanced CT, ECG, colonoscopy, gastrointestinal imaging, echocardiography, etc. Patients all received routine laboratory tests, including tumor markers and other blood tests. Patients were given appropriate supportive therapy after admission. According to preoperative evaluation, the incisions were designed through the stoma or the middle of the abdomen. All patients underwent postoperative nutritional support, albumin supplement, wound dressing, peritoneal washing and other treatments. High-risk group and low-risk group received small intestinal stoma closure operation 6 months and within 2 to 6 months after the last operation respectively. Results In low-risk group, there were 51 males and 45 females with average age of 56.4±13.8 years. In high-risk group, there were 20 males and 15 females. The small intestinal stoma in the low-risk group was caused by preventive intestinal colostomy after elective surgery for colorectal tumor. In high-risk group, the reasons included preventive intestinal stoma in 20 patients, anastomosis fistula in 4 cases and intestinal perforation or traumatic enterorrhexis in 11 cases. In high-risk group, there were 2 cases who merged in preoperative abdominal radiotherapy, 9 cases in preoperative intraperitoneal perfusion chemotherapy, 6 patients with the history of more than 3 times previous abdominal surgery, and 18 cases with severe abdominal cavity infection. In low-risk group, 88 cases were qualified in 6 min walk test and 8 cases were unqualified. In high-risk group, 30 cases were qualified and 5 cases were unqualified. Preoperative serum albumin was greater than 30 g/L in all patients of low-risk group, and 29 cases in high-risk group. There were 6 cases less than 30 g/L in high-risk group. The hospital stay in low-risk group was 8.08±0.98 days, and 12.34±7.55 days in high-risk group. Complications of abdominal cavity infection, infection of incision, incision hernia, and intestinal fistula in high-risk groups were significantly more than those in low-risk group. The mortality was significantly higher in the high-risk group. Complications of positive patients in 6 min walk test significantly increased compared with those of negative patients. Conclusions Difficult small intestinal stoma closure operation is a high risk of surgery and it has the characteristics of long operation time, more bleeding, inevitable bowel injury or bowel resection. It has higher incidence of postoperative intestinal fistula, abdominal cavity infection, infection of incision, and incision hernia. The recovery is slow, and the expenses are high.