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Ileosigmoid knot, also known as compound volvulus, is an unusual and a rare cause of intestinal obstruction. We are reporting a case of ileosigmoid knot in a 30-year-old male, who presented with lower abdominal pain. On examination, there was tenderness in the suprapubic area and later, the patient developed features of peritonitis. Exploratory laparotomy revealed a large volume of haemorrhagic fluid with gangrenous sigmoid colon, distended and gangrenous ileum twisted round the base of the sigmoid loop. Gangrenous portion of the ileum and sigmoid colon was resected and end to end anastomosis with Hartmann's procedure was done.
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