Fecalomas are masses of hardened feces that become impacted and accumulate. They are much harder in consistency than fecal impaction due to the associated coprostasis and are typically found in the sigmoid colon or rectum. Cecal fecalomas are much rarer. To date, only five cases have been previously reported in the English-language literature. We present the CT appearance of a surgically confirmed cecal fecaloma in a patient who presented with right lower quadrant pain, nausea, and vomiting, mimicking an acute appendicitis.