ABSTRACT Objective: The objective of this study is to describe a single-institution experience of patients with an Indiana pouch (IP) reservoir performed during 35 years, their surgical complications, and functional outcomes in a long-term follow-up. We believe this is the largest experience to date to be described in Latin America. Methods: A retrospective chart review of 100 modified IPs constructed from June 1987 to February 2022 was performed. We evaluated the early and late surgery-related complications as well as functional outcomes in a long-term follow-up. Results: Complete information was obtained for 100 patients. The mean follow-up was 33.1 months. The most common indication for the IP was radical pelvic surgery (56%), followed by complex lower urinary tract fistula presented in 38% of patients. Above 96% of patients were continent and the mean IP capacity was 468 mL. Early and late surgical-related complications were seen in 31% and 62.3% of the patients, respectively. During follow-up, 50% of patients had reoperation. In our series, only 23% of the patients had urinary tract infection. In the early postoperative period, six patients died. Conclusion: The IP reservoir is a suitable continent urinary diversion for patients undergoing radical cystectomy, or patients that want to improve their quality of life when their native bladder is functioning erroneously due to oncologic comorbidities. A high continence rate can be achieved successfully. However, complications occur late rather than early, with a high surgical reintervention rate.