Meckel's diverticulum (MD) is a common congenital defect of the small intestinal tract resulting from incomplete obliteration of the vitellointestinal duct. It presents with unexplained gastrointestinal bleeding, bowel obstruction, and inflammation. In rare instances, the presentation is with perforation similar to acute appendicitis with perforation. The symptoms, clinical exam, and radiological findings of our patient, a 38-year-old male, were consistent with perforated acute appendicitis; he was found to have a perforated Meckel's diverticulum intraoperatively.