The triple-lined spectroscopic triple system HD 109648 has one of the shortest periods known for the outer orbit in a late-type triple, 120.5 d, and the ratio between the periods of the outer and the inner orbits is small, 22:1. With such extreme values, this system should show orbital element variations over a time-scale of about a decade. We have monitored the radial velocities of HD 109648 with the CfA Digital Speedometers for 8 yr, and have found evidence for modulation of some orbital elements. While we see no definite evidence for modulation of the inner binary eccentricity, we clearly observe variations in the inner and the outer longitudes of periastron, and in the radial velocity amplitudes of the three components. The observational results, combined with numerical simulations, allow us to put constraints on the orientation of the orbits.