The objective of this work is to present a case report of iatrogenic sigmoid colon perforation after complicated diagnostic colonoscopy that was diagnosed and treated during the initial procedure with endoscopic clips. The patient was subsequently managed conservatively with a good result. Colonoscopic-related perforation is rare, but is the most severe complication of the procedure, associated with high rates of morbidity and mortality. In the majority of cases it is managed operatively, although under certain conditions conservative treatment is possible. Published reports about endoscopic repair of iatrogenic colonic perforation are promising.