An appendiceal abscess is a condition in which an abscess is formed around the appendix as a result of appendiceal perforation or extension of inflammation to the adjacent tissues due to aggravation of appendicitis, these occurs in about 2-6% of patients having appendicitis and more common in males less than 30 years of age. This is a 24-year-old male patient that was referred from a peripheral health care centre for abdominopelvic ultrasound scan on account of recurrent right iliac fossa pain and discomfort, fever, occasional vomiting, dysuria and increased frequency of micturition. The abdominopelvic scan showed a deep seated near oval heterogenous collection in the region of the appendix with focal ileus, surrounding hypoechoic inflammatory fluid and mobile echoes in the urinary bladder; cystitis. A diagnosis of an appendiceal abscess with cystitis was made. We report the radiologic findings of appendiceal abscess due to its peculiarity and to revise the literature.