Introduction: Angioedema is self-limited, localized subcutaneous (or submucosal) swelling, which results from extravagation of fluid into interstitial tissues. Angioedema may occur in isolation, accompanied by urticaria, or as a component of anaphylaxis. We describe a case of isolated angioedema of the bowel, a rare presentation, occurring in a man with normal C4 and C1q level. Case Description: A 23-year-old male with H/O no medical problems was admitted to our hospital for nausea, vomiting and abdominal pain for one day duration. He ate a large omelet for breakfast and few hours later developed urticaria, nausea and severe heartburn. He went to the nearest ER, where he was discharged on Benadryl and proton pump inhibitors. In the evening his symptoms progressed and nausea/vomiting worsened. He also had a colicky abdominal pain and diarrhea. The recent allergic triggers like tattoos, soaps, new foods, parenteral injections, detergents, medications like angiotensin-converting enzyme inhibitors, could not be identified. Family history was significant for allergic reaction in his father that caused him to break out in hives. Examination shows multiple urticarial lesions on both arms and shoulders. Lips are swollen and abdomen is soft with epigastric tenderness. CT scan of abdomen shows mild enteritis with mildly distended small bowel. Patient did not improve to initial conservative treatment consisting of nasogastric tube and antiemetics, but improved markedly with the steroid treatment. The patient work up including C4 level; C1 inhibitor antigenic level; C1q level was negative. Discussion: Angioedema affecting the bowel wall presents as colicky abdominal pain, sometimes accompanied by nausea, vomiting and/or diarrhea. Bowel wall edema can often be visualized by abdominal CT. It is seen in patients on ACE inhibitors and in those with hereditary or acquired C1 inhibitor deficiency. The particular case was unique because of normal C4 and C1 inhibitor antigenic level. The patient improved on antihistamines and steroids. High degree of suspicion for bowel wall angioedema is needed in a patient presenting with urticaria, severe nausea and vomiting, who is not improving with conservative treatment.