Misdiagnosis and delay in the treatment of acute appendicitis increases the risk of complications secondary to visceral perforation. Appendicular rupture into the bladder is an uncommon complication, but possibly to happen; treatment generally consists of a laparotomy with appendectomy and repair of the bladder wall. The laparoscopic approach is a viable option in cases of complicated appendicitis, even in complex and infrequent clinical scenarios. The aim of this paper is to describe a case of complicated appendicitis with bladder perforation, treated with a laparoscopic right hemicolectomy, terminal ileostomy and closure of the urinary bladder wall.