Abstract: Objective: To discuss the imaging characteristics of sigmoid volvulus(SV) with multi-slice spiral computed tomography(MSCT) and improve the level of preoperative diagnosis in patients of SV. Methods: MSCT examinations were performed in 15 cases with sigmoid volvulus proved by pathology or colonoscope reposition, and the CT imaging characteristics were analyzed and summarized retrospectively. Results: The MSCT signs of 15 cases of SV included all 15 cases had sigmoid dilated, 4 cases showed intestinal damage(bowel wall thickening, mesenteric edema, mesenterium effusion and ascites etc.). 14 cases with inverted U-shape were showed on scanogram scanning, 13 cases of round belly sign, 11 cases of beak sign on cross-section scanning. MPR showed 10 cases of cross sign and 9 cases of whirl sign; Contrast-enhanced CT and CTA showed the enhancement of bowel wall weakened in 3 cases, 1 case of small vessel occlusion of mesentery, 2 cases of mesenteric artery rotation. Conclusion: The MSCT features of SV had some characteristics, especially had a great value in guideline for clinical therapy in the estimate of intestinal damage.