Introduction: Post-transplant lymphoproliferative disease (PTLD) is an important cause of morbidity and mortality following intestinal transplantation (ITx), especially given the robust immunosuppression required. Our aim was to review a single-center PTLD experience with a focus on outcomes. Methods: An IRB-approved, retrospective review of all ITx between 1991-2012 was performed using a prospectively maintained database. All cases of PTLD were included. PTLD treatment was individualized for each patient but universally included immunosuppression reduction. Relevant medical protocols include: IMMUNOSUPPRESSION: Induction therapy is standard; agents are IL2RA (58%), OKT3/ATG (33%), NONE (9%). Maintenance immunosuppression is TAC, PRED, and MMF. RAPA is used as rescue therapy. Acute cellular rejection (ACR) is treated with PRED or OKT3/ATG. ANTIVIRAL PROPHYLAXIS: Ganciclovir prophylaxis is administered for the first 3-5 yrs post-ITx. Blood EBV quantitative PCR is monitored weekly to monthly. Pre-emptive therapy with IV ganciclovir, CMV immunoglobulin, or rituximab is given for elevated or persistent viremia. Results are reported as median (range). Results: Fourteen (13.5%) of 104 ITx recipients developed 16 PTLD cases during a median follow-up time of 59 (19-131) mos. The majority of patients were males (n=9) who received liver-inclusive allografts (n=10). Four patients (29%) were re-ITx recipients. Median age at PTLD diagnosis was 7.2 (2.6-57) yrs; only two were adults. Diagnosis was made at a median of 20 (1.7-107) mos post-ITx. 5/5 cases diagnosed in the first year post ITx were all EBV+ by immunohistochemical stains (IHC) while only 6/11 (55%) of the late PTLD cases were IHC EBV+. Overall, only 6/16 (38%) were associated with EBV viremia (EBV PCR >100 DNA copies/mL). 11/16 (69%) PTLD cases had a history of ITx ACR. PTLD was initially diagnosed in intestinal allograft (n=6), lymph node (n=5), native colon (n=2), tonsil (n=1), lung (n=1), or bone marrow (n=1). PTLD types were categorized as mixed cell (n=6), B-cell (n=5), or plasma cell (n=5). Overall patient and graft survival are both 86%, with a median survival time following PTLD diagnosis of 25 (1.2-89.3) mos. There were two deaths, with only one attributed to PTLD. Two patients are receiving ongoing therapy for recent early-stage PTLD diagnoses. Conclusion: We report excellent outcomes following PTLD in ITx recipients. Our program has a low incidence (<5%) of early PTLD diagnosed in the first year post-ITx, and early PTLD was not associated with worse survival as has been published. In addition, only 55% of our late PTLD cases were EBV-associated. This may be attributed to our program’s aggressive approach to monitoring, preventing, and treating EBV viremia. Furthermore, all ITx recipients with late non-EBV-associated PTLD are disease-free with 100% patient and graft survival. Only one patient was lost to PTLD.