Inguinal bladder herniation is a commonly seen clinical entity which represents 1–4% of all inguinal hernias. However, the extensive inguinoscrotal herniation of the bladder, known as scrotal cystocele, is very rare. Clinical findings can vary from asymptomatic findings to surgical emergencies. Radiographic imaging can play important role in the diagnosis to reduce the risk of bladder injury during hernia repair when urinary symptoms are present. Computed Tomography scan is a gold standart to identify the hernia sac. Computed tomography findings observed in axial planes, should also be carefully evaluted in other planes. Sagittal or coronal images may provide better evaluation of the hernia and its relationships with surrounding tissues. The standard treatment of inguinal bladder hernaiation is either reduction or resection of the herniated bladder followed by hernia repair. This case describes a systematic approach and role of computed tomography in the diagnosis of inguinal bladder hernaiation.