Computer tomography colonography (CTC) is an increasingly utilized diagnostic modality in Australia. CTC aims to image the entire colon, and is often used in higher risk patient populations. Colonic perforation following CTC is a rare complication, with only 0.008% of patients undergoing CTC requiring surgical intervention. Most published cases of perforation following CTC are due to identifiable causes, often involving the left colon or rectum. We present a rare case of caecal perforation following CTC, requiring right hemicolectomy. This report highlights the need for high suspicion for CTC complications, despite their rarity, and the utility of diagnostic laparoscopy for diagnosis in atypical presentations.