This is an unusual case report of 32-year-old Hispanic male who presented with an early-onset advanced stage colorectal cancer with an enterovesical fistula. A 32-year-old man presented to our institution referring suprapubic pain, urinary frequency, dysuria and tenesmus for several weeks suggesting Gouverneur’s syndrome. Patient had been treated with oral antibiotics for his recurrent urinary tract infections without resolution. Associated unintentional weight loss, decreased appetite and suprapubic pain raised concern for occult malignancy. Abdominopelvic computed tomography scan revealed a rectal mass with invasion to bladder. Colonoscopy biopsy confirmed diagnosis of moderately differentiated rectal adenocarcinoma. This report provides vital information about clinical presentations of enterovesical fistula in an imposed rectal adenocarcinoma in a young Hispanic adult with no previous family or medical history. A thorough clinical assessment must be taken to ensure accurate diagnosis and early detection of colorectal cancer in the young Hispanic population.