Herniation is one of the most frequent surgical conditions. However, the presence of a megaureter in the hernia sac or content is extremely rare. Little has been reported on this topic in the world literature, and its diagnosis has been incidentally reached either as an intraoperative finding or during different contrast imaging studies. This is the clinical case of a patient with a history of inguinal hernia who underwent a herniorrhaphy 20 years ago and presented to the emergency department with a diagnostic impression of a relapsed hernial defect. He also had poorly-controlled diabetes mellitus. During his hospital stay, a diagnosis of relapsed hernia sac containing a megaureter was confirmed, and visceral-parietal adhesions and a subhepatic cecum were found.