Pneumatosis cystoides intestinalis is a rare phenomenon presenting with multiple gas-filled cysts in the submucosal or subserosal layer of the gastrointestinal tract. Pneumatosis cystoides intestinalis can occur as a primary or secondary disease with an underlying etiology. We recently managed a case of primary pneumatosis cystoides intestinalis in a 42-year-old man with chronic abdominal pain. The case is presented with a review of the literature.