Kandria Ledesma, MD; Joseph Kim, MD; Allison Cohen, MD; Nicholas Bielawa, PA-C; Mathew Nelson, DO – Ischemic colitis is the most common form of gastrointestinal ischemia [1]. The diagnosis of ischemic colitis is made by clinical data and computed tomography (CT) imaging of the abdomen and pelvis [1]. While colonoscopy is considered the gold standard for diagnosis, this is not performed in the emergency department (ED) [2]. Few studies have been performed to describe the sonographic findings of ischemic colitis using point of care ultrasound (POCUS). We report a case that highlights the sonographic findings of ischemic colitis in a patient who had two separate visits to the ED, showcasing the utility of POCUS in making this diagnosis.