Purpose  Sliding inguinal hernias represent a small proportion of inguinal hernias but become more common with advancing age. The most recent review is based on a series published over 50 years ago. There are, however, many case reports of unusual presentations in girls.

Methods  We performed a review of a prospectively kept electronic record of all operations performed at Logan Hospital since 2003 in order to document the clinical characteristics of sliding inguinal hernias in the twenty-first century.

Results  Thirty-one males underwent predominantly anterior repair of a sliding hernia after a median of 9 months of symptoms (2.9% of all hernia repairs—32/1,092). Approximately two-thirds of hernias were left sided. There were five minor and two technical complications. Follow-up ranged from 3 weeks to 3 years. Two recurrences have been repaired.

Conclusions  Sliding inguinal hernias continue to test the surgeon’s understanding of the inguinal canal’s anatomy and technical expertise with a significant rate of technical complications and recurrence.