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Volvulus of the sigmoid colon is a condition that, in the Western world, predominately affects the elderly. In fit patients sigmoid colectomy, after a period of decompression, is the treatment of choice. However, this carries a high mortality in elderly high-risk patients. Percutaneous endoscopic colostomy (PEC) has been reported as a treatment for those who are considered high risk for surgery. We report the successful use of PEC in an 87-year-old lady, for the treatment of recurrent sigmoid volvulus, without complication. This procedure has also been used effectively for colonic pseudo-obstruction, constipation, and obstructed defecation. There are various complications associated with PEC, the most serious of which is tube migration and fecal peritonitis. Our experience supports the use of PEC to treat sigmoid volvulus in those too frail for colonic resection.