Background: Transverse colon surgery is technically demanding because of the anatomical mobility of the colon and its complex vascular supply. In sub-Saharan Africa, late presentation and emergency conditions remain frequent, but dedicated data on transverse colon surgery are scarce. Objective: To describe the indications, surgical procedures and postoperative outcomes of transverse colon surgery in four referral hospitals of Douala, Cameroon. Methods: We conducted a retrospective multicenter descriptive study over a 10-year period (January 2012–December 2021). All patients who underwent surgery involving the transverse colon were included. Sociodemographic characteristics, operative indications, surgical procedures and in-hospital postoperative outcomes were analyzed descriptively. Results: A total of 103 patients were included. Mean age was 44.68 ± 27.63 years (range: 7 months–83 years), with male predominance (sex ratio 2.4). Emergency surgery accounted for the majority of cases. Acute generalized peritonitis was the leading indication (33.0%), followed by intestinal obstruction (22.2%) and abdominal trauma (17.4%). Right hemicolectomy (41.4%) and transverse colectomy (35.9%) were the most frequently performed procedures. Postoperative complications occurred in 18.4% of patients, dominated by surgical site infections (13.6%). In-hospital postoperative mortality was 3.9%. Conclusion: Transverse colon surgery in Douala is predominantly performed in emergency settings and is associated with a substantial burden of postoperative infectious morbidity. Improving early diagnosis and perioperative care is essential to improve outcomes.