Total rectal prolapse (procidencia) is a clinical state in which all layers of the rectum protrude through the anal canal. The etiology is not completely understood. It is an uncommon situation and patients must be diagnosed early; cases should be reduced manually in the emergency department until ischemia occurs in order to decrease complications. Some additional techniques have been presented in the literature in cases of failure using manual reduction. Procedural sedation and analgesia procedure can improve patient comfort and the success rate of manual reduction alone or in addition to these techniques. In this case report, we present a total rectal prolapse reduced after procedural sedation via intravenous ketamine administration in the emergency department.