Seventy nine patients with sigmoid volvulus were managed at Attat Hospital in Central Ethiopia between 1980 and 1993. A total of 25 (32%) of the patients had gangrenous bowel while 54 (68%) had viable sigmoid colon. Seventy three of the patients were managed by resection and primary anastomosis. Two (9%) of the 23 patients with gangrenous bowel who had resection and primary anastomosis died while for those with viable sigmoid colon the mortality rate was 4% ( 2 out of 50). The paper discusses the management of sigmoid volvulus both with viable and with gangrenous bowel. It is recommended that whenever possible, resection and primary anastomosis should be the procedure of choice in the management of sigmoid volvulus.