Sigmoid volvulus is a rare cause of acute intestinal obstruction that is seen in elderly patients, and the clinical presentation is that of abdominal pain and distension. The diagnosis of this condition is made by performing an abdominal x-ray or a computerized tomography scan that will show the characteristic features of sigmoid volvulus. The management of sigmoid volvulus can be divided into endoscopic therapy and surgical therapy. Endoscopic therapy involves endoscopic detorsion, but this is associated with a high recurrence rate. Surgical therapy involves performing a sigmoid resection and anastomosis or a Hartmann’s procedure. The choice of which surgical procedure will depend on whether the sigmoid volvulus is complicated or uncomplicated. In this review, we will look at the management of sigmoid volvulus by investigating the role of endoscopic detorsion, the surgical management, which includes sigmoid resection and anastomosis, and Hartmann’s procedure.