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This webinar was presented at 16 March 2022 by Prof Mikko Pakarinen from New Children’s Hospital and University of Helsinki, Finland and Prof. Tomas Wester, Head of Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden. Total colonic aganglionosis is a potentially life-threatening condition with significant morbidity. The purpose of surgical reconstruction is to create bowel continuity with preserved fecal continence. There are limited data showing long-term outcomes. Most studies are hampered by small sample size. There is no consensus regarding reporting of long-term outcomes. This webinar will focus on the management of TCA and the decision making process. Management should focus on providing acceptable bowel function, quality of life and growth, as well as preventing enterocolitis. Children with total colonic aganglionosis should be followed by dedicated multidisciplinary teams and adolescents should be offered transition to adult care. The ARM webinar series covers all aspects of paediatric colorectal surgery, in particular (congenital) anorectal malformations. They are joint presentations between ERNs eUROGEN and ERNICA, and are supported by ARM-Net. ERN eUROGEN is the ERN for rare and complex urorectogenital diseases and conditions. For more information, visit www.eurogen-ern.eu. ERN ERNICA is the ERN for rare Inherited and Congenital (digestive and gastrointestinal) Anomalies. For more information, visit https://ern-ernica.eu. The ARM-Net Consortium is a group of professionals and patient representatives that aim to exchange data and knowledge to improve clinical care and to perform research on congenital anorectal malformations. For more information, visit https://www.arm-net.eu