Pneumatosis cystoides intestinalis(PCl) is a rare disease of undetermined etiology which is characterized by multiple gas-filled cysts in the wall of the small or large intestine or both. It is associated with various medicosurgical conditions including organ transplantation. Fewer than 50 cases of PCI occurring after organ transplantation including 4 cases of cardiac transplantation have been reported in the world literatures. We report a 47-year-old man of PCI who suffered from right lower quadrant abdomina) pain for 1 week. He was taken heart transplantation due to acute myocardiac infarction and ischemic cardiomyopathy 1 year ago. On plain abdominal X-ray revealed the multiple clustered localized collections of gas in the ascending and hepatic flexure of colon. Co]onoscopy showed the typical finding of PCI, which was multiple variable size protruding masses which apperared as round, soft, and somewhat bluish colored cysts. After the puncture of the above cystic mass using endoscopic injection needle, we can observe the deflation of the above ass. This is the first case in Korea.