Actinomycosis is a slowly progressive chronic granulomatous bacterial infection caused by an anaerobic gram-positive bacillus: Actinomyces Israeli.Thinking about thisdiagnosis in the right iliac fossa is uncommonas it usually shows through a clinical aspect of acute appendicitis, a Crohns disease or even a tumor of the ileocolic region. We report the case of a young female patient admitted for an iliac fossa pain and a palpable mass, mimicking a Crohns disease during laparoscopic exploration, only to conclude its a retained diagnosis of actinomycosis, after doing an ileocecal resection and anatomopathological analysis The purpose of this case report is to focus on the different aspects of this infection in the ileocecal regionwhich can be mistaken at firstand that is only supposed to be treated medically by antibiotics for months, with a simple biopsy to confirm the diagnosissince surgery can be mutilating.