Colonoscopic examination is used in both diagnosis and treatment of sigmoid volvulus. If colon ischemia is detected during a colonoscopy, urgent surgery is unavoidably accepted. Here we presented an ischemic sigmoid volvulus and its resolution as seen through colonoscope after successful medical treatment. The patient was a 79-year-old male with Alzheimer's disease and cerebrovascular disease. Emergency surgery was canceled, and an elective laparoscopic sigmoid resection was done 1 month later uneventfully.