SummaryThirty‐eight patients having 44 episodes of sigmoidal volvulus were treated in a 50‐bed hospital in northern Iran over an eight‐and‐one‐half‐year period. The possible influence of diet on the high incidence of this disease is discussed.Nonoperative decompression, elective resection and anastomosis, primary resection and anastomosis, and obstructive resection were used in treatment of these patients.The over‐all operative mortality rate was 26 per cent, and the patient mortality rate was 20 per cent. In the operative cases when there was no gangrene, the death rate was 8 per cent, and in those having gangrene it was 58 per cent. Resection and anastomosis, in 14 patients not having gangrene, was associated with a mortality rate of 14 per cent. Factors influencing these results are discussed, and an outline of treatment is suggested.