Inguinoscrotal hernias containing urinary bladder are very rare. There are only a few cases described with perforation in the scrotum. This illness is a severe and should be kept in mind with any patient complaining of a scrotal hernia. We report a case of bladder perforation caused by inguinoscrotal hernia with incarceration and severe sepsis in a 93-year-old male. A computed tomography scan with excretory phase was used to diagnose the disease. A laparotomy with partial bladder resection and herniotomy were performed. Our patient recovered well from surgery. Ten days after surgery, a cystography was performed showing no extravasation.