Torsion of the uterus is a rare obstetric complication. This report describes a 270-degree uterine torsion associated with placental abruption, maternal shock, and fetal demise. At laparotomy, the uterus and ovaries were necrotic. This patient presented in a manner typically managed by labor induction, thus delaying her diagnosis of uterine torsion. © 2005 Elsevier Inc. All rights reserved.