The patient was a 79-year-old woman with a hard mass apparent in the right groin.Computed tomography (CT) revealed a water density mass of 4 × 3cm in the right inguinofemoralregion. The mass protruded from the abdominal cavity through the medial side of the femoral artery and showed a small amount of untrapped air. Inguinal approach revealed the gangrenous appendix in femoral hernia sac, and appendectomy and McVay repair were performed. She was discharged from hospital 7 days postoperation after an uneventful recover. Femoral hernia has a high incidence of strangulation. Signs of intestinal obsrtruction do not precede intestinal necrosis, when Mekel's diverticulum or appendix is strangulated. Therefore, precise diagnosis of hernia content is essential in deciding urgency for operation in femoral hernia.