The authors conducted a 20-year review of the records of patients with torsion of greater omentum or appendices epiploicae admitted to the Vancouver General Hospital. Presenting signs and symptoms, operative findings and some recent reports are examined and conclusions are given. Diagnosis of the condition is rarely made preoperatively owing to the lack of specific symptoms. When a straightforward diagnosis of appendicitis has been made, yet a normal appendix is found, torsion of omentum should be considered and excluded.