The common presentations of caecal cancer are anaemia, weight loss and obstructive symptoms. Caecal cancer perforation and abscess formation are rare and mostly intra- or retroperitoneal.,We present a case of abdominal wall abscess secondary to penetrating caecal cancer, the inability of computed tomography scan in aiding the diagnosis and successful surgical excision.,When caecal cancer presents atypically, the preoperative diagnosis is difficult, but complete excision is possible even with abdominal wall penetration.