Gastric pneumatosis is a well-recognized clinical entity that is described in the literature as either a subtype of pneumatosis cystoides intestinalis or gastric emphysema. Gastric pneumatosis may be due to a variety of causes, which are classically categorized as infectious or non-infectious in nature. We report a case of gastric pneumatosis and pneumoperitoneum associated with a bowel obstruction secondary to an incarcerated umbilical hernia. Literature pertaining to gastric pneumatosis was reviewed and the different classifications and etiologies briefly described. Understanding the pathophysiology of gastric pneumatosis and the various causes can help in deciding when to explore and when to safely observe patients with this condition.

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