Ischemic colitis (IC) is the most frequent form of intestinal ischemia, affecting mostly older people with a reported incidence of 16 cases per 100,000 person-years. It is caused by a sudden cut in the blood flow to the colon that compromises its perfusion and functionality. It is transient in most cases and resolves without sequelae, whereas some patients develop colonic necrosis and gangrene that can be life-threatening. Therefore, a high index of suspicion, prompt diagnosis, and treatment are vital in the management of ischemic colitis. We aimed to review the literature to enhance the understanding and awareness of ischemic colitis. We reviewed the literature for ischemic colitis; clinical manifestations, risk factors, and approach to diagnosis. Articles were chosen from the PubMed database, and selected studies were subjected to a thorough review. The clinical features of ischemic colitis differ depending on the clinical circumstances as well as the intensity and duration of the ischemia. A diagnosis of ischemic colitis can often be established clinically based upon history, physical examination, and clinical setting. Moreover, it can be confirmed by a lower endoscopy and abdominal computed tomography (CT) which is beneficial for ruling out other etiologies of abdominal pain.