Neonatal necrotizing enterocolitis, the most common gastrointestinal emergency in neonates, typically affects the preterm infants and carries high mortality. Classic clinical trad consists of abdominal distension, bloody stools, and pneumatosis intestinalis. Occasionally, signs and symptoms may not be classic and a number of papers have highlighted the difficulty of relying on radiological features to make a definitive diagnosis of necrotising enterocolitis. We report herein a case of neonate referred to us as a case of obstructed inguinal hernia and was diagnosed as a necrotizing enterocolitis perforation revealed by a rare manifestation of pneumoscrotum.