The syndrome of iliopectineal bursitis is an important differential diagnosis of a painful swelling in the inguinal region. Symptoms are local swelling and pain, radiation of pain along the femoral nerve, troubles of arterial or venous circulation and even dysuria or dysmenorrhoea in case the bursa penetrates into the pelvis. The diagnosis is established by conventional radiology (signs of osteoarthritis as one of the pathogenetic reasons), ultrasound (liquid mass lateral to the femoral vessels), punction (clear fluid, eventually synovial cells), contrast injection (dimension of the bursa and communication to the hip joint) and computed tomography (dimension, relation to hip and vessels). The treatment is the excision of the bursa, if conservative therapy is not successful. The excision requires tedious, cautious dissection because of the important structures adjacent and a possible communication to the hip joint must be eradicated.