The improvement of surgery in the treatment of ulcerative colitis prompts us to consider its impact on the quality of life of the patients. Obviously, it is mandatory that the results after surgery should be better than the symptoms which elective surgery is designed to treat. A review of the literature was carried out on the current status of quality of life in patients with ulcerative colitis before and after surgery using a PubMed source. The rate of success after restorative proctocolectomy for ulcerative colitis is 95%. The quality of life after restorative proctocolectomy compared with other procedures is better, especially in the long term. About 90% of patients would undergo pouch surgery again after restorative proctocolectomy, while 53% of patients submitted to other procedures would have a restorative proctocolectomy. Restorative proctocolectomy is the gold standard for patients with ulcerative colitis who are suitable for surgical treatment, though future prospective trials are needed in order to establish when elective surgery for ulcerative colitis is indicated.