Pneumatosis Cystoides Intestinalis (PCI) is a rare condition with overall incidence of 0.03% and is characterized by the presence of gaseous collections within the submucosa and/or subserosa of the intestinal wall. A 51-year-old female with history of chronic hepatitis-C and alcohol dependence presented with sharp right upper quadrant pain, worse with eating and associated with bilious vomiting and loose, non-bloody stools for 3-4 days. Physical exam depicted mild tenderness in the right upper quadrant. US Abdomen showed no evidence of gall stones or cholecystitis. Subsequent CT-Abdomen showed right colon wall thickening with pneumatosis and ileocolic mesenteric venous gas. The initial differential included ischemic or infectious colitis but CBC, CMP, lipase, amylase, lactate and stool studies including Clostridium difficile were normal. Since there were no signs of bowel ischemia, the patient was managed conservatively. Water-assisted colonoscopy revealed mild erythema and erosions in ascending colon. The biopsies showed increased intramucosal and submucosal eosinophils suggesting eosinophilic colitis. She was treated with high flow oxygen therapy and empiric elimination diet which led to resolution of symptoms. PCI may involve small intestine (20-51.6%), colon (36-78%) or both (2-22%). It can be primary or idiopathic (15%) and secondary (85%). Secondary PCI has been reported in association with disorders of digestive system (peptic ulcer, IBD, appendicitis, necrotizing enterocolitis) or respiratory (COPD, cystic fibrosis), inflammatory, infections or trauma. Our patient did not have any of these disorders. This is probably the first report of PCI in association with eosinophilic colitis. PCI may be caused by mechanical, pulmonary, bacterial or biochemical processes. Mucosal injury and increased intraluminal pressure, or both can lead to intrusion of intraluminal gas into the bowel wall. In our case, the mucosal injury might have been caused by eosinophilic colitis. PCI may be asymptomatic or present with abdominal pain, diarrhea, intestinal obstruction or perforation. CT is the diagnostic modality of choice. In the absence of clinical and laboratory findings of bowel ischemia or other complications, the patients can be managed conservatively with hyperbaric therapy, antibiotics and special diets. Surgery may be elected in cases where medical therapies fail. In conclusion, eosinophilic colitis is a benign cause of PCI which can be managed conservatively.