ABSTRACT: INTRODUCTION: Torsion of the vermiform appendix is a rare disorder, which causes abdominal symptoms indistinguishable from acute appendicitis and is found by chance during the laparotomy. CASE PRESENTATION: We report a case (a 76-year-old male) suffering of torsion of the vermiform appendix with fecalith. It was twisted 540 degrees in an anti-clockwise direction. Appendectomy was done. CONCLUSION: Appendiceal torsion may be assocated with the presence of fecalith. This case is the oldest one among the patients with appendiceal torsion reported to literature.