This book aims at filling a gap in relation to the pathophysiology of the inguinal region and the genesis of groin protrusions. While inguinal hernia is a widespread disease and hernia repair accounts for the most frequently performed surgical procedure, these two aspects have been unsatisfactorily investigated, so that to date there is no shared hypothesis on how visceral protrusion through inguinal barrier occur. Exact knowledge on the pathogenesis is fundamental for adequately managing a disease, otherwise all curative approaches would  not be  evidence-based, but merely empirically identified  and with uncertain outcomes carried out. Moreover, in absence of pathogenetic certainty, formulating guidelines simply results in an unjustified methodology harbinger of polemics and controversies.