A 67-year old man had a large irreducible right inguino-scrotal hernia which had been enlarging for 8 years. During the last two weeks he had felt a 'dragging' pain in the right groin. He had no fever, anorexia or evidence of intestinal obstruction. The scrotum was neither tender nor tense. Surgery revealed an indirect inguinal hernial sac containing the caecum, ileum and appendix. The appendix was inflamed but not perforated. Histopathological confirmation was obtained. The appendix was covered by adjacent inflamed mesentery. The ileum was normal and devoid of a Meckel's diverticulum. After performing an a appendicectomy, the bowel was returned to the peritoneal cavity. The hernial sac was divided close to the neck and a Shouldice repair done.