Objective To investigate the characteristics and treatment for pneumatosis cystoides intestinalis （PCI）. Methods Data of 12 PCI patients admitted to General Hospital of Tianjin Medical University from 1997 to 2015 were analyzed. The causes， endoscopic characteristics， therapeutic effects and prognosis were evaluated. Results Four cases were primary PCI due to long-term exposure to trichloroethylene or unknown reasons， while 8 other cases were secondary to Behcet′s disease， connective tissue disease， emphysema， diabetes， therioma， etc. Endoscopic findings included bubble-like， linear，cobblestone-like， graped or beaded gas cysts， involving sigmoid in 6 cases， ascending colon in 3， descending colon in 2， duodenum in 2 and rectum in 1. After combination of medicinal and endoscopic treatment， symptoms of 8 patients were relieved， and the condition of 2 patients improved, while 2 patients died of malignancy. Conclusion Pneumatosis intestinalis is a rare disease， usually secondary to other diseases， which can be diagnosed by colonoscopy and ultrasonic endoscopy. Pathogenesis of PCI is still unclear. Single PCI can be cured with endoscopic resection. Multiple PCI can be managed with cyst clipping， antibiotics and intestinal flora regulator. Treatment of the original disease and early detection of complications can improve the prognosis and reduce recurrence of PCI.