With improvement in laparoscopic skills and increased surgeon experience, the recurrence rates of laparoscopic hernia repair have become almost equivalent to those reported for conventional hernia repair. Chronic pain after hernia repair is an important adverse outcome and has been extensively discussed in the literature. Unfortunately, there is poor understanding of the pre-, intra-, and postoperative factors that cause the various pain syndromes. These pain syndromes could be somatic or visceral in nature (depending on the underlying cause) and can be difficult to treat. Initial treatment of all these pain syndromes is initially conservative with reassurance, anti-inflammatory medication, cryotherapy, and local nerve blocks. In case conservative measures fail to relieve patient's symptoms and other underlying causes have been excluded, groin exploration may be required. When exploring the groin in this situation, the surgeon must be prepared for possible mesh removal, which may be difficult because of the dense adhesions. Neurectomy, neurolysis, or neuroma excision should be reserved as a last resort. Occasionally, patients may develop infertility or the dysejaculation syndrome. These could be due to underlying injury to the vas deferens or extensive cicatrization around the vas deferens due to mesh-induced inflammation. These conditions, although rare, can be difficult to treat and usually have less than satisfactory outcomes.