We report the case of a 97-year-old male with recurrent gastric volvulus who was successfully treated with nasogastric tube-assisted endoscopic reduction followed by percutaneous endoscopy-assisted gastropexy with gastric wall fixation. The nasogastric tube facilitates endoscopic reduction by enhancing the procedure's efficiency. In contrast, percutaneous endoscopy-assisted gastropexy provides an effective, minimally invasive method to prevent the recurrence of gastric volvulus, even in patients with poor overall health. This case highlights the clinical utility of these combined approaches in managing gastric volvulus in elderly patients with significant comorbidities.