b.Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of gas-filled cysts within the wall of the gastrointestinal tract. We report the case of a 90-year-old male who presented for an elective laparoscopic cholecystectomy. Upon entering the abdominal cavity, countless gas collections involving all the small bowel, mesentery, and parts of large bowel were discovered. This was consistent with PCI. Previous CT imaging noted small bowel diverticular perforation and non-specific pneumoperitoneum. The patient recovered well from the cholecystectomy. This case highlights the importance of correlating radiological findings with clinical presentation, as PCI can be asymptomatic but mimic life-threatening conditions such as bowel perforation. Early recognition of benign PCI and appropriate conservative management can prevent unnecessary surgical intervention and improve patient outcomes.