Pylephlebitis is a thrombotic occlusion of the portal vein or its branches secondary to infection in regions that drain to the portal venous system. Clinical presentation is often atypical, and patients may initially present with non-specific abdominal symptoms. We report a case of pylephlebitis secondary to inflammatory colitis depicted by CT scan in a 35-year-old female admitted for acute abdominal pain associated with vomiting and fever.