Abstract Aim There is a lack of consensus regarding the definition of chronic postoperative inguinal pain (CPIP). The World Guidelines for Hernia Management (WG) suggests a broader definition of CPIP that does not include pre-operative assessment which decreases comparability between studies. According to the International Association for the Study of Pain (IASP) a clinical assessment of extent and cause of pain is done comparing pre- and postoperative pain, mandating a physical examination at two separate occasions. The aim of this study is to find the real incidence of CPIP with a clinically relevant definition compared to the traditional WG CPIP definition, one year following inguinal hernia repair where both pre- and postoperative clinical evaluation is included. Material & methods A prospective observational cohort study performed during one year at a hernia clinic. Patients were clinically assessed and filled out validated questionnaires both pre- and postoperatively. Patients with significant or increased inguinal pain one year after surgery were evaluated for probable causes of chronic pain. Results 574 patients were included of which 372 were selected for surgical hernia repair. 265 (71%) filled in pre- and postoperative questionnaires. According to WG 9 (3%) patients experienced more pain 1 year after surgery however of those, 5 patients (55%) had non-surgical causes of pain. 3 patients (1.1%) had clinically relevant CPIP one year after surgery (IASP). Conclusions Evaluating patient perceived pain both pre- and postoperatively, including a clinical examination of patients with possible CPIP, is imperative to correctly evaluate CPIP following inguinal hernia surgery.