Gastric volvulus is a rare cause of acute abdomen, and its complexity increases when associated with congenital anomalies. We report an exceptional case of gastric volvulus with perforation in a female patient, which was accompanied by asplenia, jejunal diverticulosis, and absent colonic attachments. To our knowledge, this combination has not been previously documented. This case highlights the need for further research into the mechanisms behind such rare anatomical associations.