Background: Urachal anomalies are rare normally presenting during childhood.They are difficult to diagnose and surgical treatment is always needed to prevent recurrence. Case Report:A 28 year old male presented with a red tender umbilical swelling that was confused with an umbilicalhernia. The correct diagnosis of a urachal fistula was reached after performing a CT scan. The patientwas initially treated with oral antibiotics and complete surgical excision of the fistulous tract wascarried out at a later stage after controlling the infection. Conclusions: Staged resection is the treatmentof choice in urachal anomalies associated with sepsis. Surgical excision of the urachal remnant is necessaryto prevent recurrence.

Keywords: Diagnosis, Differential, Fistula - surgery, Hernia, Umbilical - diagnosis, Sepsis - diagnosis, Tomography, X-Ray Computed, Umbilicus, Urachus - surgery