Lead points that are the cause of an ileocolic intussusception are rare in infants , as is successful reduction using barium . Air reduction of an intussusception with a pathologic lead point has not been previously reported. We report a case of an infant with an ileocolic intussusception secondary to a duplication cyst that was successfully reduced with air. The pathologic lead point was recognized at the time of reduction and confirmed with water-soluble contrast. Air is both a diagnostic and therapeutic contrast agent.