Abstract Aim Evaluating groin pain still evades many clinicians with at times difficulty in determining the cause of pain when no true hernia exists. This study’s aim was to evaluate a simple and novel scoring system which is reproducible, to help determine whether conservative measures or surgery is recommended for the management of groin pain attributable to inguinal disruption. Methods A retrospective analysis of all patients from 2018 - 2020 that underwent surgery or conservative management for inguinal disruption with at least a 1 year follow up were evaluated. The scoring system is based on MRI and ultrasound imaging as well as clinical findings, with scores given from -2 to +2 based on the defined findings listed. Sensitivity and specificity analysis was conducted for each potential score cut off point. Results A total of 172 patients were evaluated with 33 patients (19%) undergoing conservative management and 139 patients (81%) undergoing surgery. The mean SPoRT score of the physiotherapy group was statistically significantly lower than that of the surgery group (-1.33 vs 1.84, p = 3.55 x 10-25). An optimal cut off of ≤ 0 for physio and ≥ 1 for surgery was established, yielding a sensitivity of 90.9% (95% CI: 75.7% - 0.981%), a specificity of 89.2% (95% CI: 82.8% - 93.8%) and an area under the curve (AUC) of 0.9356 (95% CI: 0.874 – 0.997). Conclusion SPoRT score of ≤ 0 can recommend a patient should undergo conservative measures or physiotherapy as a mainstay of treatment with a score of ≥ 1 recommending surgery.