Magnetic resonance imaging follow-up of a patients with ischemic colitis resolved promptly. Ischemic colitis (IC) of left side colon in a 57 year old woman with a recent history of acute hypertensive crisis, who presented with left lower quadrant pain and massive rectal bleeding. A: Endoscopic procedure showed multiple necrotic area; B and C: Contrast-enhanced computed tomography (CT) and axial T2 fast-recovery fast-spin echo sequence (FRFSE) magnetic resonance imaging (MRI), after 32 h from CT, showed acute IC (Type I CT and MRI) with wall thickening, three layer sandwich sign and a mild amount of free fluid in the paracolic gutter; D and E: 2D coronal reformat CT and coronal T2 FRFSE MRI, at the same time, showed the entire involved tract; F: Ischemia risolved without complications with conservative therapy as shown in the follow-up MRI.