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Scrotal herniation of the bladder is a rare event and can be associated with bladder outlet obstruction, bladder infarction and renal impairment. This condition is also associated with a significant mortality rate. We present a case report of extensive scrotal cystocele involving 90% of the bladder in which the diagnosis was suggested by KUB, pelvic ultrasound, and pelvic CT imaging showing distorted bladder anatomy and the presence of several large bladder calculi.