Background: Para-stomal hernia is a common complication following fecal diversion. It has been attributed to many factors and site of stoma creation in relation to the rectus abdominis muscle is believed to be one of them. This belief was recently debated. The aim of this research was to detect if the site of stoma creation whether through (trans-) or away from (para-) the rectus abdominis muscle has a role in the development of such a complication. Methods: Sixty patients undergoing fecal diversion were included in a prospective controlled study. They were randomly allocated into one of two main groups; whether to undergo a para-rectus stoma creation or a trans-rectus stoma creation. All patients were followed-up for one year for the development of para-stomal hernia. Results: There was no statistically significant difference between the two groups as regard to the incidence of developing para-stomal hernia. Conclusion: Creating stomas away from the edge of the rectus abdominis muscle i.e. at a para-rectus site is not a risk factor for developing para-stomal hernia.