Urologists often care for adult patients with neurogenic bladder. Adult patients with neurogenic bladder may have concommitant neurogenic bowel. Neurogenic bowel may be refractory to conservative management. The Malone antegrade continence enema (ACE) has been successful in pediatric neurogenic bowel. Little experience has been described among adult neurogenic bowel patients. We describe the technique of the ACE and review our results for adult neurogenic bowel.