Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal (GI) tract. It presents most frequently in patients under two years of age and more rarely in later adulthood. Complications of Meckel's diverticulum are even less common and can be difficult to distinguish from other more common abdominal pathologies due to nonspecific signs and symptoms. As a result, less common disease presentations, such as Meckel's diverticulitis with perforation, can be difficult to diagnose preoperatively, especially in the adult population. We discuss a case of a patient who presented with symptoms of acute appendicitis, which was later revealed to be Meckel's diverticulum complicated by Meckel's diverticulitis with localized perforation.