Ischemic disease of the colon (Ischemic colitis) describe a more focal type of damage in the large intestine, increasingly recognized in the elderly. It is related to occlusion of the mesenteric artery, ligation during vatcular surgery, embolic episode, diabetes melitus, arthero sclerosis, polyarteritis nodosa, rheamatoid arthritis, systemic lupus erythematosus and amyloidosis.  Clinical manifestations are acute bloody diarrhea and abdominal pain. A patient had referred to the emergency department with bloody diarrhea, at first, she considered a case dysentryor ulcerative colitis. Progression of clinical course ischemic and inflammatory colitis had considered as differential dingnosis. In rectosigmoidoscopy there were neumeric blood clots in the lumen and three biopsies  was taken. In the absence of active inflammation and parasite, the mucosal atrophy and fibrosis extended to muscularis mucosa, guid pathlogist to ischemic colitis. The patient treated with supportive therapy and there is not complication and recurence already.