We report a case of mobile cecum presenting as incarcerated scrotal hernia complicated by necrotizing fasciitis. A 54-year-old man, with no relevant medical history, presented with 3-day duration of a painful large right scrotal mass associated with high fever. The comprehensive workup confi rmed the diagnosis of a right inguinoscrotal hernia. Surgical
intervention with exploratory laparotomy through midline incision of the abdomen revealed a right incarcerated hernia of the cecum with gangrene and perforation as well as right necrotizing fasciitis of the scrotum. The patient successfully underwent partial resection of the colon and terminal ileum, debridement and herniorrhaphy. We highlight this unusual case because surgeons are encouraged to be aware of this condition, which is diffi cult to recognize before exploration.