BACKGROUND Single-layer intestinal anastomoses have been constructed conventionally using an interrupted suture technique. It is however, increasingly popular to perform such anastomosis using a continuous suture. METHODS One hundred and eighty consecutive patients with 254 continuous single-layer anastomoses performed over a 4 year period were included in the study. Sixty-one patients underwent oesophagectomy, oesophageal bypass or gastrectomy, 32 underwent biliary bypass, hepatic, biliary or pancreatic resection and 88 had colorectal operations. The median age was 67 years. RESULTS There were 254 anastomoses of which four leaked (1.6%). Fifteen patients (8.3%) died in hospital. CONCLUSIONS These results show that the single-layer continuous suture technique is safe in gastrointestinal anastomoses.