A 62-year old woman with an extensive medical history received a double barreled wet colostomy (DBWC) after a total pelvic exenteration. The DBWC is a relatively unknown procedure, where a colostoma is created with two separate compartments and separate openings for urine and faeces. The aim of this article is to compare the DBWC to separate colostomy and urostomy with a case description and review of the available literature. Literature search revealed three retrospective studies comparing DBWC with separate colostomy and urostomy, with a total of 267 patients. The available literature showed no difference in mortality and morbidity with DBWC compared to separate urostomy and colostomy. The conclusion is that DBWC can be considered after total pelvic exenteration.