Background: Temporary digestive stomas are frequently used in colorectal and emergency digestive surgery. Although digestive continuity restoration (DCR) improves quality of life and intestinal function, it remains associated with substantial postoperative morbidity. Data from sub-Saharan Africa remain scarce, particularly regarding predictors of adverse postoperative outcomes. Objective: To evaluate surgical practices, postoperative outcomes, and determinants of morbidity following digestive continuity restoration in three tertiary referral hospitals in Cameroon. Methods: A retrospective multicenter cohort study was conducted between January 2014 and December 2023 in three referral hospitals in Douala, Cameroon. Patients undergoing digestive continuity restoration after temporary digestive stoma formation were included. Sociodemographic, clinical, operative, and postoperative variables were analyzed. Factors associated with postoperative morbidity were identified using multivariable logistic regression. Results: Among 311 eligible patients, 264 were included in the final analysis. The mean age was 38.5 ± 18.7 years, and 55.7% were male. Infectious diseases (36.3%) and neoplastic conditions (26.1%) were the leading indications for temporary stoma creation. Colostomies accounted for 83.0% of all stomas. Peristomal mini-laparotomy was the most commonly used approach (59.1%). Overall postoperative morbidity reached 30.7%. Thirty-day mortality was 2.3%, while overall mortality during follow-up reached 5.7%. Previous stoma-related medical complications independently increased the risk of postoperative morbidity (aOR 4.64; 95% CI 2.16–9.97; p<0.001). ASA III status (aOR 3.45; 95% CI 1.40–8.47; p=0.007) and delayed restoration beyond 180 days (aOR 2.29; 95% CI 1.06–4.96; p=0.035) were also associated with increased morbidity. Conversely, the peristomal mini-laparotomy approach was protective (aOR 0.28; 95% CI 0.11–0.71; p=0.007). Conclusion: Digestive continuity restoratio