Colonoscopy has become the principal method for diagnosis, treatment, and follow-up of colorectal disease. However, colonoscopy is an invasive procedure with an associated risk of complications. Especially, perforation of the colon and rectum during colonoscopy is a rare but serious complication. The choice of conservative versus surgical treatment for this complication remains controversial. In general, conservative treatment is reserved for patient in good general health with good bowel preparation and absence of signs of peritonitis during 24 to 48 hours following the perforation. Conservative management consists of intestinal rest, intravenous fluids and antibiotics, nasogastric tube decompression, and frequent clinical examination. In case of iatrogenic perforation, if the wound is immediately closed with clips, contamination of the peritoneal cavity can be minimized. We report here a patient who sustained iatrogenic rectal perforation caused by diagnostic colonoscopy that was successfully treated by endoscopic clipping therapy. (Intestinal Research 2005;3:154-156)