We present a case of solitary colonic ganglioneuroma, a rare benign peripheral nerve tumor, found during a routine colonoscopy, in a patient without clinical symptomatology of systemic disease. Case Presentation: A 57-year-old African-American male with a history of untreated chronic hepatitis C cirrhosis with viral load of over 4 million copies, seizure disorder, mild mental retardation, hypothyroidism, hypertension, diabetes mellitus type 2, presented to the gastroenterology clinic for scheduling of a screening colonoscopy. At the time, he was completely asymptomatic. On colonoscopy, one 4mm sessile polyp was resected in the sigmoid colon and was histologically diagnosed as a ganglioneuroma (GN). Colonic ganglioneuromas are classified as hamartomatous polyps that are composed of ganglion cells, nerve fibers, and enteric nervous system cells. GNs of the gastrointestinal tract can be classified into three groups based on the size and the number of polyps: polypoid GN, ganglioneuromatous polyposis, and diffuse ganglioneuromatosis. Polypoid GNs, seen in patients with Cowden's syndrome, are small, sessile or pedunculated polyps that have a similar appearance to hyperplastic and adenomatous polyps. Ganglioneuromatous polyposis, seen most commonly in patients with MEN IIB, NF1, Cowden's syndrome, usually manifests as more than 20 sessile or pedunculated polyps. Lastly, diffuse ganglioneuromatosis, seen in MEN IIB7 and NF1, involves proliferation of neuronal cells in the entire colon, but does not extend into the ileum. Conclusion: The finding of an asymptomatic, solitary GN in our patient does not warrant more frequent colon cancer screening given its benign nature.