&NA;A report is presented describing an exceptional case of spontaneous appendicocutaneous fistula (only six cases in the literature). Chronic appendiceal fistulas—that is primary communications between the appendix and an adjacent hollow viscus or the skin—occur rarely. Various types of appendicular fistula are considered and the literature is reviewed. Symptoms depend on location of the fistula and organ involved. The pathogenesis of such an unusual lesion is discussed. Appendectomy and excision or closure of the fistula is the radical therapy when the diagnosis is made.