Hydrogen atom abstraction from aliphatic (2a, 2b) and aromatic (2c, 2d, 2e) aldehydes by the triplet nπ* state of 1-acetylisatin (1) yielded triplet (isatin ketyl-aldehyde acyl) radical pairs, which follow an out-of-cage pathway in subsequent reactions to give a series of radical coupling products 4−7. This out-of-cage mechanism is supported by examination of the primary products at various degrees of conversions during the course of the reaction, by the results of addition reactions of thermally generated isatin acyl radical with neutral 1, and by calculation of the charge density distribution in the acyl radicals and in ground state 1. Therefore, the oxygen-philic attack of the acyl radical, which had escaped out of cage from the triplet radical pair, at the C(3) carbonyl oxygen atom of a ground state 1 selectively afforded the thermodynamically more stable addition radical B. The recombination of two radicals B gave the 3-indolinone dimers 4 and 5 as diastereomers, while coupling of B with the isatin ketyl furnished the dihydroisoindigo derivative 6. Isatide 7