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We report the first case of a clinically diagnosed incidental appendiceal carcinoid tumor contained in an incarcerated inguinal hernia without inflammation of the appendix. A 67-year-old white man underwent elective open repair of an incarcerated right inguinal hernia containing small bowel, cecum, appendix, and ascending colon. He was found to have a grossly abnormal mass at the tip of his appendix. Appendectomy was performed, and histopathologic analysis confirmed the presence and adequate resection of a neuroendocrine tumor. It is important for general surgeons to be aware that unusual presentations of appendiceal tumors may not be associated with appendiceal inflammation or related symptoms.