Imaging of diffuse immune-related colitis with a skipped distribution in a 49-year-old female with metastatic melanoma. After 4 months of treatment with Nivolumab (n = 12 cycles), patient presented with Grade 2 diarrhea and abdominal pain. CECT showed colonic wall thickening involving sigmoid (white arrows in A), descending and ascending colon (white arrows in B). Mucosal hyperenhancement was present in the ascending colon (white arrowheads in B). Nivolumab was discontinued until the resolution of the diarrhea and CECT after 4 months showed a normal colonic wall (white arrowheads in C).