Gastric pneumatosis is rare, with causes ranging from benign to lethal. The purpose of this pictorial essay is to present a series of cases of gastric pneumatosis, review the causes, and demonstrate how computed tomography (CT) can help guide management. A range of primary gastric pathology can cause air in the wall of the stomach. However, gastric pneumatosis may reflect intraabdominal pathology arising from other hollow viscera, with indicators of the extragastric etiology on CT.