Pneumatosis cystoides intestinalis (PCI) is a condition characterized by the presence of gas-filled cysts in the submucosa or subserosa of the gastrointestinal tract. PCI has been described by various radiographic methods but its laparoscopic features have not been previously described. We report a case of a 77-yr-old male with marked ascites and radiographic evidence of pneumatosis cystoides intestinalis of the ileum who underwent a laparoscopy to determine the cause of his ascites. The characteristic laparoscopic features of PCI are described, and its radiographic features are reviewed.