An 83-year-old woman was seen at the hospital for sudden vomiting and a sense of abdominal discomfort. The patient was diagnosed with primary small intestinal volvulus when abdominal computed tomography (CT) demonstrated a “whirl sign” in the small intestine loops around the superior mesenteric artery (SMA). In emergency surgery, the jejunum and ileum were twisted 360° counterclockwise around the SMA, and the intestine caused ischemic change. The blood flow recovered quickly after detorsion, eliminating the need for intestine resection. But three months later, the patient was seen at the hospital for the same symptom again. We diagnosed primary small intestinal volvulus recurrence because abdominal CT demonstrated the “whirl sign”. Again, the jejunum and ileum twisted 360° counterclockwise around the SMA. The blood flow recovered quickly after detorsion, but we added bowel fixation to prevent a recurrence. There are a few reports of recurrence, but the necessity of small intestine fixation was suggested in cases of primary small intestinal volvulus.