Due to the infrequency of intestinovaginal fistula, our understanding of this condition hails from case reports and small case series.  In the present study, we identified all patients the  ACS-NSQIP database to glean trends in the surgical management and their complications for this complex condition. Can we identify risk factors to help determine the optimal surgery in these patients, and thereby influence the choice of resection vs fecal diversion, and open vs laparoscopic surgery?