Here we have the first reported case of a spontaneous entero-scrotal fistula in Australia. A 71-year-old male from an independent group home presented to a tertiary hospital with presumed scrotal abscess and necrotic testicle. On detailed groin examination and CT abdomen pelvis, he was found to have an enterocutaneous fistula originating from the terminal ileum eroding through the right scrotal wall. The intraoperative findings revealed a Richter’s hernia with the wall of the terminal ileum within the deep ring. Spontaneous entero-scrotal fistula is a rare complication of inguinal hernias. Prior to 2005 (Samad and Sheikh), it was only reported in infants. Majority of the reported adult cases have been from under-resourced and under-developed countries. Only two out of eleven such cases have been reported in a developed country, both in the United States. Our aim is to report this rare complication in Australia and also shed light on the health literacy in the country.