Chronic pain caused by an occult hernia can be a difficult clinical diagnosis and may require additional investigative modalities. The aim of this study was to demostrate the accuracy of ultrasound in diagnosing occult hernia in patients with recurrent inguinal pain and negative clinical examinations. over a period of three years, a total of 76 patients were referred for ultrasound examination with clinically suspected occult inguinal hernia. patients with positive US scans were offered surgery, while those with negative US findings were offered further imaging or other diagnostic tests. The ultrasound examination of the inguinal region was conducted using a 5-10MHz linear probe. The scan was performed with the patient supine and erect positions, in a relaxed state, as well as during couching and during a valsava manoeuvre. Overall, ultrasound diagnosed 31 inguinal hernias and all 31 patients with positive scans underwent surgery. Surgery confirmed the ultrasound diagnosis in 30 patients, having only 1/31 no hernia at operation (100% ultrasound sensitivity and 96,9% specificity). Patients undergoing surgery showed complete symptom resolution at a three-month follow-up. Conclusions: this study confirm that ultrasound is capable of accurately diagnosing groin hernia and this may justify its use in patients with chronic groin pain due to a suspected occult hernia.