| Summary: | Introduction We encountered an extremely rare case of a vesicocutaneous fistula due to vesical diverticulitis with stones. Case presentation A 78‐year‐old male patient presented to our department with complaints of suppurative discharge in the suprapubic area. Computed tomography revealed an enlarged prostate, a vesical diverticulum with stones located on the ventral side, and an aberrant connection between the anterior bladder wall and the external surface of the skin. The patient was diagnosed with a vesicocutaneous fistula due to vesical diverticulitis and was successfully treated with a multidisciplinary approach including vesical diverticulectomy with stone removal and nonviable tissue debridement. The patient continues to receive regular outpatient follow‐ups with urinary catheter changes. Conclusion Vesicocutaneous fistulas due to vesical diverticulitis with stones are extremely rare. We should be aware that a vesical diverticulum with stones located on the ventral side might pose a high‐risk factor for the formation of a vesicocutaneous fistula in elderly patients.
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