Background Amyand's hernia is described as the presence of an appendix vermiformis in the inguinal hernia sac. The incidence of Amyand's hernia is approximately 1% of all inguinal hernias. Amyand's hernia is diagnosed intraoperatively or preoperatively with radiologic examinations. Case Report Two cases of Amyand's hernia, with and without acute appendicitis, are reported here. Why Should an Emergency Physician Be Aware of This? Amyand's hernia is a rare entity, and physical signs, laboratory results, and symptoms are not always helpful in diagnosis. Preoperative diagnosis of Amyand's hernia is not straightforward, and is generally an incidental finding during surgery. Imaging modalities, including ultrasound, can be very useful for making this rare diagnosis.