Intestinal evisceration is a rare event and few cases of colostomy rupture have been documented in the medical literature. Complications of colostomy surgery vary in incidence, with most episodes occurring in the immediate postoperative timeframe, including necrosis, hemorrhage, cellulitis and dehiscence. Here, we document the case of a 35-year-old male patient with a history of immunodeficiency, multiple comorbidities and squamous cell carcinoma of the anus who experienced a unique instance of colostomy evisceration weeks after initial surgery. The patient originally underwent surgery for a sigmoid colostomy for the alleviation of irritation secondary to anal disease. Weeks later, after a traumatic fall injury, he experienced colostomy evisceration. This case will review the factors leading up to this event that put the patient at risk for poor wound healing and ultimately colostomy rupture.