In a retrospective study, 72 patients with sigmoid volvulus were treated by resection and primary anastomosis during a three and half year period. Patients with sigmoid volvulus but no clinical evidence of gangrene were included in this review. No attempt was made at sigmoidoscopy and deflation prior to performing an emergency laparotomy. The outcome of surgery was assessed in terms of perioperative complications and postoperative mortality. There were four (5.5%) cases of anastomotic leak and four deaths giving a mortality rate of 5.5%. We believe that resection and primary anastomosis should be the operation of choice for most patients with sigmoid volvulus without gangrene.