AbstractFetal inguinoscrotal hernia is an uncommon occurence in the prenatal life, and published literature on it is scarce. This is a type of indirect hernia that results from abnormal migration of the small bowel into the scrotum via the patent processus vaginalis. We present a case of prenatal diagnosis of right sided fetal inguinoscrotal hernia, with contralateral hydrocele and severe fetal growth restriction confirmed as Trisomy 18 in subsequently performed chromosomal analysis. The index case presented at 35+2 weeks of gestation with a right sided solid scrotal mass with a regular contour, mixed echogenic texture with a few echo-free areas, a distinctive arterial supply and characteristic peristaltic movements. Fetal demise was noted one week later. The diagnosis was confirmed by postnatal examination. Prenatal diagnosis of fetal inguinoscrotal hernia should be followed up with detailed anatomical assessment and chromosomal analysis if indicated by the presence of additional abnormalities. Isolated cases require surgical repair in the neonatal period to avoid sequelae and complications.