Groin hernias are among the most common indications for surgery worldwide, affecting both men and women, with a significantly higher prevalence in men. These hernias occur when intra-abdominal contents protrude through a weakened area in the groin region, most commonly as inguinal or femoral hernias. The pathogenesis of groin hernias is a complex interplay of genetic predisposition, connective tissue abnormalities and mechanical strain. While watchful waiting is an option for some asymptomatic patients, surgical repair remains the definitive treatment, with both open and minimally invasive techniques available. Tension-free mesh repair has significantly reduced the overall recurrence rates and is now the standard approach in adults in most clinics. However, tissue-based repairs are still preferred in select populations such as children, teenagers and those in resource-limited settings. Advances in laparoscopic and robotic-assisted techniques offer benefits such as reduced postoperative pain and faster recovery. Despite surgical advancements, complications, such as chronic postoperative pain and recurrence, continue to pose challenges. Future research aims to refine surgical techniques, look at mesh-related complications, develop bioengineered meshes and explore the genetic basis of hernia formation.