Inguinal hernias are very common in men. We report a rare case of intestinal perforation following blunt abdominal trauma in a 80-year-old man with pre-existing inguinal hernia. A careful and serial physical examination, with the information obtained from the computed tomography (CT) scan guides the prompt surgical exploration. This case demonstrates that external forces, that may seem too trivial to cause intraperitoneal injury, can cause significant injury when applied to a patient with a hernia. It is possible to repair the intestinal perforation and inguinal hernia in the same operation.