Collagenous colitis is a form of microscopic colitis. Chronic profuse watery diarrhea, abdominal pain, and weight loss are common presentations. Elderly females are most commonly affected. Causes include nonsteroidal anti-inflammatory medications, selective serotonin reuptake inhibitors, duloxetine, and proton pump inhibitors. Collagenous colitis traditionally has been associated with “normal” appearing mucosa at colonoscopy with characteristic histologic features of collagen deposition in the subepithelial layer. Reports of distinct endoscopic findings have emerged which describe pseudomembranes, mucosal vascular pattern alteration, erythema, nodularity, and fractures.