Acute abdomen is sudden abdominal pain, requiring urgent diagnosis and investigation to avoid serious complications/outcome by providing immediate medical care and or surgery. A thorough history taking and physical examination of abdomen are must for early diagnosis and surgical intervention. A careless physical examination can miss inguinal hernia which may be obstructed or strangulated and can lead to disaster. In this our case planned and careful examination prevented the disaster as the patient was diagnosed as a case of acute appendicitis with pain in RIF.