This case report demonstrates a case of amebic colitis, which was originally a typhloappendicitis, and was operated because of misdiagnosed as an acute appendicitis. Post-operative exacerbation was then occured and a huge perforation of 12cm in length was resulted. The entire colon and 18cm of the terminal ileum were invariably involved. If this case was accurately diagnosed during or immediately after appendectomy, the conditions of the patient would be better; and no need to suffer the second operation, because conservative antiamebic treatment will be enough to eradicate the infection. Although the confirmatory diagnosis of amebic infection is by means of immunology and pathology; radiology could provide an easy and quick evaluation of the site of infection; clinical types; degree of involvement; trace of complications; as well as follow up of treatment!