This article presents the case of a 26-year-old man who was diagnosed with pneumatosis cystoides intestinalis, a rare consequence of colonic graft-versus-host disease, after CT imaging revealed free air tracking within the bowel wall and abdomen. His presentation with hiccups, abdominal and neck distension, along with diarrhoea was also unusual, and this case highlights the need for a high index of suspicion when treating post stem cell transplant patients.