Geophagia, the habit of eating earth, soil, or clay, is common among African women and frequently encountered during pregnancy. The condition is relatively benign; grave surgical complications are infrequently observed. We describe an adult, nonpregnant, African woman with sigmoid colon perforation and fatal peritonitis due to geophagia. Geophagia is a rare cause of colonic perforation and peritonitis and a high degree of suspicion must be employed to identify this disorder.