Introduction: De Garengeot hernia is a rare condition in which the appendix is trapped within a femoral hernia. It accounts for less than 1% of femoral hernia cases and is more common in females, making its occurrence in males particularly unusual. Diagnosis is challenging, as symptoms and laboratory findings are often non-specific, and no standardized surgical protocol exists. Case Presentation: We report the case of a 69-year-old male who presented with a 4-day history of a tender, irreducible right groin lump. He was afebrile with stable vital signs and unremarkable laboratory investigations. Computed tomography revealed the appendix within the right femoral hernia sac without signs of acute appendicitis. Laparoscopic exploration demonstrated the appendix tip within the femoral sac, with a bulky and gangrenous mesoappendix. A laparoscopic caecectomy was performed, followed by a low groin incision to reduce and excise the hernia sac. The femoral canal was narrowed with interrupted prolene sutures. The patient recovered uneventfully and was discharged the following day. Clinical Discussion: De Garengeot hernia accounts for <1% of femoral hernias, occurring predominantly in post-menopausal women. Presentation mimics incarcerated femoral hernia, with limited sensitivity of ultrasound and CT, although CT remains most reliable. No standardized operative strategy exists, with both open and laparoscopic approaches described. In this case, a hybrid laparoscopic caecectomy with open femoral repair was performed, avoiding mesh due to gangrenous appendicitis. Conclusion: This case underscores the diagnostic and therapeutic challenges of De Garengeot hernia and highlights the value of ongoing documentation to inform future surgical practice.