The aim of this study was to describe women's experience of living with a colostomy after rectal cancer surgery. Interviews with five women about their experiences were subjected to thematic content analysis. The findings showed that receiving a cancer diagnosis gave rise to thoughts about life and death. For the women to feel comfortable, the information and health-care measures need to focus on supporting them through the entire process, also when the treatment is completed. After the surgery, the women adjusted to living with colostomy and carried on as before the cancer diagnosis, but they constantly worried about leakage or flatulence. The women were happy to have survived the cancer and this realization helped them to accept and have a good life with colostomy. In conclusion, women with colostomy because of rectal surgery need specific rehabilitation and nursing care that focuses on adjustment to temporary or permanent changes in life. © 2010 Blackwell Publishing Asia Pty Ltd.