Background: Inflammatory myofibroblastic tumor (IMT) is a tumor composed of myofibroblasts and a mixed inflammatory infiltrate that rarely undergoes malignant transformation. The most common sites of involvement include the lung, liver and orbit, but it has been reported to occur in nearly every site of the body, including oral cavity and soft tissue. Although common in other sites, such a tumor in rarer location including inguinal region is likely to be missed/misdiagnosed and hence need to be reported. Case Report: We present an unusual case of a 50 year old male with bilateral inguinal swelling attended our institute few days back with history of local excision twice, but still showing recurrence. He was treated by wide local excision with bilateral orchiectomy this time. Histopathological report revealed inflammatory myofibroblastic tumor with malignant transformation. Adjuvant radiotherapy was also given and patient taken in followup. At one year of serial follow-ups, the patient is disease-free both clinically and on investigations, indicating successful combined surgery and radiotherapy in the treatment of malignant IMT. Conclusion: IMT of the inguinal region is very rare. Its clinical presentation may resemble malignant tumor, so IMT should be kept as differential diagnosis. The recommended treatment is complete surgical resection with adjuvant corticosteroid. Adjuvant radiotherapy may be considered depending upon the location of the tumor.