Pneumatosis intestinalis is radiologically diagnosed through the detection of intramural gas in the intestines. While 15% of the cases have been evaluated to be primary or pneumatosis intestinalis of unknown causes, the rest of the cases appear secondarily to various other diseases. The 44-year-old male patient, who had been in the follow-up program for chronic renal failure, presented with complaints of abdominal pain. The patient’s computerized abdominal tomography results revealed air images in some segments of the small bowel wall. The patient was diagnosed with peritonitis related to peritoneal dialysis accompanied by primary pneumatosis intestinalis and he was discharged without any problems following medical treatment. While pneumatosis intestinalis can develop due to a disease which can be treated in outpatient conditions in some cases, it can sometimes prove to be a sign of fatal diseases if surgical intervention is delayed. It is significant to evaluate this finding as a whole with the patient’s complaints, medical history, comorbid conditions, physical examination and laboratory results, and other radiological analyses in order to prevent delays in diagnosis and to offer accurate treatment.