BACKGROUND: An umbilical hernia with a narrow neck and a wide sac is more prone to complications, thus the morphology of an umbilical hernia is crucial in determining the development of symptoms and consequences. The hernia sac-neck ratio and ultrasonographic ndings are used in this study to take into account the physical properties of the hernia in order to anticipate the onset of symptoms and complications. MATERIALS AND METHODS: This study is a prospective observational study conducted in Victoria Hospital from February 2021 to July 2022.Atotal of 115 patients with umbilical hernia underwent an ultrasound of abdomen to note the size of the neck of the hernia. The diameter of the hernia sac was measured clinically for both emergency and elective patients intra-operatively. The ratio was calculated and compared. RESULTS: The 115 research participants included 52 complicated cases and 63 uncomplicated cases. The mean hernia neck size in complicated case was 2.07 cm and in uncomplicated group was 2.53 cm. According to the ROC curve analysis, the mean hernia sac neck ratio, the study's area of interest, was higher in the complicated group than in the uncomplicated group (2.78 vs. 2.42) and was linked with a 49% sensitivity and 70% specicity at a cutoff ratio of 2.6. CONCLUSION: This study showed that the Hernia sac neck can be used as a specic tool for predicting complications and that individuals with a smaller neck and a bigger sac are more likely to have complications.