Purpose: Meckel’s diverticulum is the most common embryological anomaly of the small bowel that is rarely seen in adults. It is caused by the incomplete closure of the vitelline or omphalomesenteric duct. Those who are symptomatic from Meckel’s diverticulum have varied clinical presentations, which creates significant challenges with diagnostic and management options. This presentation aims to raise awareness about this rare condition. Method: We report a case of a perforated Meckel’s diverticulitis. Ethics approval was gained, the patient’s electronic medical records were accessed and intraoperative images were taken of the specimen. A literature review was conducted and extensive search of electronic databases including Medline, Scopus, Embase, Cochrane and PubMed was performed. Results: We report a case of a 47-year- old male who presented to the hospital with clinical signs of appendicitis but was found to have perforated Meckel’s diverticulitis with faecoliths on computed tomography imaging abdomen and pelvis (CTAP) and laparoscopy. Furthermore, histopathology revealed an ectopic gastric tissue cell type, which is a rare finding. This was definitively managed surgically with laparoscopic resection of Meckel’s diverticulum and appendicectomy. Conclusion: Meckel’s diverticulitis in adults is a very rare and often difficult clinical diagnosis that can present like acute appendicitis. Investigation with CTAP is useful, and laparoscopic resection is the preferred treatment. The presence of ectopic gastric tissue predisposes to significant ulceration and a high risk of perforation.