Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, which is usually asymptomatic. In patients with intestinal ascariasis, Meckel's diverticulum may pursue a silent course or may be complicated by diverticulitis, gangrene and perforation. We report an unusual complication of volvulus of Meckel's diverticulum and an adjacent segment of ileum due to incarceration of worm bolus in a narrow based Meckel's diverticulum leading to gangrene and perforation.