The volume-outcome relationship for surgical procedures is well established in the U.S. healthcare system. Studies of adult ulcerative colitis (UC) demonstrate that high volume centers consistently produce better surgical outcomes with fewer complications than low volume centers. Recently, published guidelines from the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) recommend that pediatric UC surgeries be completed at high volume centers performing ≥10 pediatric colorectal surgeries annually.