Chronic ischemia of the small bowel is classically described as presenting with abdominal pain associated with eating (intestinal angina). Here we describe the cases of two patients with chronic small bowel ischemia who presented atypically with painless watery diarrhea and weight loss. These cases suggest that the clinical spectrum of chronic small bowel ischemia may be wider than previously appreciated. Chronic ischemia of the small bowel should be included in the differential diagnosis for painless watery diarrhea in the context of weight loss.