Epiploic appendagitis is a rare cause of acute abdomen. Depending on the onset point, it can imitate every cause of acute abdomen, colon disease, and cecal appendicitis, making the pre-operative diagnosis extremely difficult. The case of a young woman that came at the emergency department with a pain in the iliac fossa will be examined hereinafter. At first, the case has been incorrectly interpreted as an acute appendicitis and suddenly, after the surgical exploration, she has been found affected by cecal appendagitis. The epiploicae appendix has been removed together with the vermiform appendix through laparoscopy. We will check the related literature too and discuss the ways to solve this diagnostic dilemma. General surgeons must be aware of this disease and consider it in the differential diagnosis of the acute abdomen. [ABSTRACT FROM AUTHOR]