BACKGROUND Amyand's and Littre's hernias are 2 rare types of inguinal hernias, which constitute less than 1% of all types of hernias. Amyand's hernia is characterized mainly by the presence of a vermiform appendix in an inguinal hernia sac, whereas Littre's hernia includes a protrusion of a Meckel's diverticulum into the hernial sac. CASE REPORT In this article, we report a case of co-existence of Amyand's and Littre's hernia in the same sac of a groin hernia. To the best of our knowledge, this is the first case report of a patient with the appendix and Meckel's diverticulum inside the hernia sac. Although there was no sign of inflammation, we performed an incidental appendectomy and partial enterectomy. We continued with the repair process with polypropylene mesh using Lichtenstein technique. The patients showed no signs of complication or recurrence of the hernia within 1 year from the day of the surgery. CONCLUSIONS The aim of this article is to present for the first time the occurrence and the repair of a combined Amyand's and Littre's hernia. Additionally, in this study, we were the first to use polypropylene mesh to repair both hernias in an elderly patient after performing appendectomy and enterectomy, avoiding any complications or recurrence of the hernia 12 months following the surgery.