Portal venous air is a rare but potentially grave radiologic sign. The routine use of abdominal CT and ultrasound allows the detection of minimal amounts of portal air, often at an asymptomatic stage. The first diagnosis to consider by both frequency and gravity is intestinal necrosis which carries a 75% mortality. And yet there are also benign etiologies of portal venous air, usually asymptomatic, which do not require surgical intervention. The aim of this study is to describe the differential diagnosis of portal venous air and its clinical management.