Colonic volvulus is an important entity to consider in any pregnant patient with abdominal pain. X-ray and colonoscopy can be useful to obtain the earliest diagnosis, leading to surgical intervention if necessary. Limited use of x-rays with shielding of the fetus is of minimal risk and useful for early diagnosis of volvulus. Colonoscopy may confirm or exclude the diagnosis of colonic volvulus, detect mucosal ischemia, and avoid the requirement for emergency surgery by reducing the volvulus in cases in which ischemia is not present. If surgery is necessary for a cecal volvulus, cecostomy is a viable option because of a low rate of morbidity and subsequent volvulus recurrence.