The purpose of the present study was to retrospectively evaluate the nature and significance of unexpected focal 18-FDG uptake localized by PET/CT within the intestinal tract. Methods. The data of 4,033 PET/CT were retrospectively reviewed. One hundred and eighty PET/CT showed unexpected focal uptakes (patients with known intestinal neoplasia were excluded). Among them, 42 patients corresponding to 47 focal uptake sites were investigated by endoscopy or surgery. Results. Height endoscopy results were negative (17%). We found 25 adenomatous polyps (53.2%), 10 neoplasms (21.3%) and 4 inflammatory lesions (8.5%). 18-FDG uptake values were not statistically different between the 4 groups. Conclusion. Eighty-three percent of unexpected intestinal foci of hypermetabolism are either inflammatory, malignant or premalignant lesions. These results justify systematic investigation of these lesions.