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Inguinal hernias are common; the lifetime risk for men is 27% and for women 3%. (1) It has been estimated that worldwide over 20 million repairs of inguinal hernia are carried out each year, the specific operation rates varying between countries from around 100-300 per 100 000 population per year. (2) In the United Kingdom some 100 000 inguinal hernias are repaired each year and in the United States 750 000. In the past decade the outcomes for surgery for inguinal hernia have been improved dramatically by the routine use of prosthetic mesh. Laparoscopic surgery has not affected surgery for inguinal hernia appreciably because of the increased costs and the reluctance of general surgeons to learn this complex procedure to correct a minor abnormality. Improvements in the delivery and quality of inguinal hernia surgery in the future will depend on the development of improved prosthetic mesh materials to reduce the incidence of chronic groin pain, which is now higher than recurrence rates. Furthermore, improvements in the organisation of care should include comprehensive education of patients, clinical nurse specialists, outpatient care for most patients, …