Littré hernia is the rare protrusion of a Meckel's diverticulum (MD) through a hernia sac. We present a rare case of strangulated MD in a woman patient in her 90s, which required a small intestine resection. She presented with 1 day of groin swelling, no features of bowel obstruction and an irreducible hernia on examination. On CT, there were radiological features of strangulation, and the patient was taken for an emergency operation. Findings included a femoral hernia containing strangulated MD with clinical features of ischaemic small bowel. The affected segment was resected, and a side-to-side anastomosis was performed. She recovered well postoperatively. This report emphasises that the clinical diagnosis of Littré hernia can be insidious, and the importance of imaging to aid decision-making.