OBJECTIVE: Enterocolic lymphocytic phlebitis (ELP) is a rare venous-specific gastrointestinal inflammation with challenging preoperative diagnosis. We aimed to characterize its clinicopathological spectrum. PATIENTS AND METHODS: This narrative review synthesizes evidence from 85 published cases (9-81 years) from 50 articles to characterize ELP's clinicopathological features and diagnostic pitfalls, along with its differentiation from other vasculitides, such as Behcet's disease, systemic lupus erythematosus, mesenteric inflammatory veno-occlusive disease, idiopathic myointimal hyperplasia of the mesenteric veins and IgG4-related diseases. RESULTS: ELP has a wide range of clinical and histological presentations, it predominantly affects the right colon/small bowel, mimicking acute abdomen. Diagnosis relies on postoperative histopathology showing venular lymphocytic infiltration. CONCLUSION: ELP represents a underdiagnosed clinicopatologic entity, a diagnosis of ELP is predominantly made after histological resection.