The investigators describe 2 cases of intestinopericardial fistula. The patients presented with cardiac tamponade and underwent pericardiocentesis, followed by surgical intervention. Both patients survived and were discharged in stable condition. In conclusion, intestinopericardial fistula is a rare and life-threatening disorder that can present in a variety of manners, including pneumopericardium, cardiac tamponade, and pericarditis. Early identification of the disease coupled with prompt surgical intervention maximizes a patient's chance of survival and reduced morbidity.