Can a pediatric hernia affect fertility? This is the most common question I have encountered in the outpatient and inpatient departments for more than 10 years, and it is also the most important question for parents of children. Today, I would like to briefly introduce this issue to parents of children. What are the factors that can affect the fertility of a child with a hernia? This is mainly divided into two aspects, before and after treatment. The biggest risk factor before treatment is hernia impaction. According to the relevant literature, the chance of hernia impaction in children around 1 year old is 9 – 31%, and once impaction occurs, the chance of testicular ischemia reaches 30 – 36%, which is the place where sperm is produced. The second major risk factor before treatment is a huge hernia. During my tens of thousands of actual surgeries over the past ten years, I have found that many children with huge hernias often have relatively poor vas deferens development to some extent, so early surgery is necessary for children with huge hernias. The risk factors after treatment are mainly improper treatment methods. This treatment method was banned by the Ministry of Health a long time ago, but some clinics still hold up the pretense of “no surgery, cure hernia” to cheat parents for the sake of pure economic interests. In the case of a large number of children who have not been cured, the sclerosing agent injected during the surgery leads to adhesions and destruction of a significant portion of the vas deferens, and in some cases even to testicular atrophy, which has a self-evident effect on fertility. Another influencing factor after treatment is the factor of the patch. For children over 10 years old, the recurrence rate is higher with simple high ligation of the hernia sac, so the treatment means to choose traditional repair or patch repair, while common polypropylene patch, which is prohibited for children under 18 years old, can be used for unmarried and infertile youth over 18 years old, but related reports show that polypropylene patch may lead to vas deferens local scarring and have some effect on fertility. In conclusion, having a hernia is not a terrible thing, as long as you see a specialist in a timely and regular manner and use a treatment method that is suitable for you, there is usually no adverse effect on fertility.