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ABSTRACT   BACKGROUND: Typhoid fever afflicts people of low socio-economic status in developing nations. Although ileal perforation is a common complication of typhoid fever in tropical Africa, caecal perforations related to typhoid fever are uncommon. They present atypically in children under of five years old. Such presentation could include cough and caecal perforation. CLINICAL DESCRIPTION: We report a two-year old girl with intraoperative and histopathological evidence of a perforated typhoid caecitis who had right hemicolectomy. CONCLUSION: Caecal perforations may occur in children as young as two years of age following enteric fever. High index of suspicion is needed for early detection. KEYWORDS: Caecal perforation, children, complication, typhoid, two years