Background: Sigmoid surgery is a major component of digestive surgery in sub‑Saharan Africa, where emergency abdominal conditions remain frequent. Multicenter local evidence is limited. Objective: To describe indications, operative procedures, and postoperative outcomes of sigmoid surgery in four referral hospitals in Douala, Cameroon. Methods: Retrospective descriptive multicenter study over a 10‑year period. Patients aged ≥15 years undergoing surgery involving the sigmoid colon were included. Sociodemographic variables, indications, procedures, morbidity and mortality were analyzed using IBM SPSS v25. Results: A total of 116 patients were included; 68.1% were male. Mean age was 47.6 ± 15.6 years. Main indications were sigmoid volvulus (19.8%), rectosigmoid junction cancer (19%), sigmoid cancer (12.9%) and rectal cancer (12%). Sigmoid colostomy was the most frequent procedure (56.9%). Laparotomy was the predominant approach. Overall morbidity was 11.2% and mortality 5.1%. Conclusion: Sigmoid surgery in Douala is dominated by emergency indications, particularly volvulus and complicated colorectal cancers. Strengthening early diagnosis and gradual implementation of minimally invasive surgery may improve postoperative outcomes.