Inguinal hernias and intra-abdominal malignancy are both common phenomena and their co-existence cannot be rare. Colon carcinomas are reported to be the most common cause of both intrasaccular and saccular tumours (1) but the occurrence of small intestine carcinoma inside an inguinal hernia has not been reported. We describe the first case--a leiomyosarcoma of the ileum--which was also complicated by irreduction.