Umbilical granuloma is a very common cause of umbilical discharge. It is managed by chemical cauterization or simple thread ligation. However, it can be a differential diagnosis of patent vitello intestinal duct and this should be ruled out before managing such patients. We report a case of a 10-week-old male infant referred by his General Practitioner for silver nitrate cauterisation, with a diagnosis of suspected umbilical granuloma (UG). The child underwent subsequent exploratory laparotomy and bowel anastomosis.