The basic clinical manifestation of inguinal hernia is a prominent mass in the inguinal region. In some patients, the mass is small at the beginning, just entering the inguinal canal through the deep ring, and there is only a mild sensation of swelling at the hernia ring, which makes the diagnosis more difficult; once the mass is obvious and passes through the superficial ring or even enters the scrotum, the diagnosis is easier. In addition to a mass in the inguinal region and occasional swelling and pain, there are no other symptoms of easy recurrent hiatal hernia. The mass often appears during standing, walking, coughing, or labor, is mostly pear-shaped with a stalk, and may descend into the scrotum or labia majora. When the lump is pressed with the hand and the patient is asked to cough, there may be a swelling sensation of impact. If the patient rests flat or pushes the mass toward the abdominal cavity with the hand, the mass may disappear by retracting into the abdominal cavity. After retraction, the superficial ring was extended through the scrotal skin with the finger, and the superficial ring could be felt to be enlarged and the abdominal wall to be soft; at this time, if the patient was asked to cough, there was a sensation of impact on the fingertips. The hernia mass does not appear when the patient is asked to stand up and cough by pressing the finger against the deep ring of inguinal canal; however, once the finger is removed, the hernia mass is seen to bulge out from the upper to the lower part of the body. If the hernia contents are intestinal collaterals, the mass is soft, smooth, and bulging when percussed. There is often resistance to retraction; once retracted, the mass disappears more quickly and often makes a grunting sound when the intestinal collaterals enter the abdominal cavity. If the contents of the hernia are large omentum, the mass is tough and has a turbid sound on percussion, and the retraction is slow. In addition to slightly more distension and pain, the main feature of a refractory hiatal hernia is that the hernia mass cannot be completely retracted. In addition to incomplete retraction of the hernia mass, sliding hiatal hernia also has symptoms such as indigestion and constipation. Although sliding hernias are uncommon, the cecum or sigmoid colon that slides into the hernia sac may be mistaken for part of the hernia sac and cut open during hernia repair surgery, so special attention should be paid. Intrusive hernias usually occur in hiatal hernias, where a sudden increase in intra-abdominal pressure, such as forceful labor or defecation, is the main cause. The clinical manifestation is a sudden increase in the size of the hernia mass with significant pain. The hernia mass cannot be retracted by lying down or pushing by hand. The mass is tense and hard, and there is significant tenderness. The contents of the incarcerated mass are often mild. The local pain is often mild; if it is intestinal collaterals, not only the local pain is obvious, but also the clinical manifestations of mechanical intestinal obstruction such as abdominal cramps, nausea, vomiting, cessation of defecation and exhaustion, and abdominal distension. Once the hernia is embedded, there is less chance of self-retraction; the symptoms of most patients gradually worsen. If left untreated, it will develop into a strangulated hernia. In case of intestinal wall hernia (Richter’s hernia), it is easy to be ignored because the local mass is not obvious and there is not necessarily intestinal obstruction. The clinical symptoms of strangulated hernia are more severe. However, in the case of necrotic perforation of intestinal collaterals, the pain may be temporarily relieved by a sudden decrease in the pressure of the hernia mass. Therefore, if the pain is relieved and the mass is still present, it cannot be considered as an improvement. In cases of longer strangulation, acute inflammation of the tissues covered outside the hernia can occur due to infection of the hernia contents and invasion of the surrounding tissues. In severe cases, sepsis may occur. Direct inguinal hernia is commonly seen in the elderly and frail. Its main clinical manifestation is when the patient is upright. A half spherical mass appears at the medial end of the groin, just above the pubic symphysis, without pain or other symptoms. The neck of the hernia sac is wide and the contents of the hernia are directly ejected from the posterior to the anterior. Therefore, the hernia mass mostly disappears on its own after lying down and does not need to be reset by hand pushing. The hernia never enters the scrotum and rarely becomes entrapped. The contents of the hernia are often small intestine or large omentum. The bladder can sometimes enter the hernia sac and become a sliding rectal hernia, in which case the bladder becomes part of the hernia sac and should be noted during surgery. The inguinal hernia is divided into four types according to the size of the hernia ring defect, the firmness of the transverse abdominal fascia around the hernia ring and the integrity of the posterior wall of the inguinal canal. Type I: hernial ring defect ≤1.5 cm in diameter (about one finger tip), the transversalis fascia around the ring is tense, and the posterior wall of the inguinal canal is intact; Type II: hernial ring defect 1.5-3.0 cm in diameter (about two finger tips), the transversalis fascia around the ring is present but thin and in reduced tension, and the posterior wall of the inguinal canal is incomplete; Type III: hernial ring defect ≥3.0 cm in diameter (more than two fingers), the transversalis fascia around the ring is thin and Type IV: recurrent hernia.