Background: The processsus vaginalis follows the round ligament or testis via the inguinal canal into the labium majus or scrotum during development. During the first year of life, the canal of Nuck is usually eliminated. Failure to achieve complete obliteration results in an indirect inguinal hernia or canal of Nuck hydrocele

Case Presentation: A 4 years old girl brought by her parents to pediatric emergency department of King Fahad Medical City, Riyadh with swellings in the right groin for one month. Local examination reveled a pear shaped 3×2cm irreducible, fluctuant swelling in the right inguino-labial region with no cough impulse. Ultrasound reveled cystic lesion seen occupies the right inguinal canal. It measures 3.5cm×1.7cm. It shows internal debris. The patient postoperative course was uneventful, and she was discharged the next day.