Introduction The pathophysiology of pain following groin hernia repair is not well understood. Hernias may be associated with a traumatic event, and covered by accident compensation (ACC), or be spontaneous in onset. The purpose of this study was to evaluate the impact of accident compensation status on pain. We hypothesised that accident compensation would be associated with higher pre and postoperative pain scores and less improvement in pain. Methods Consecutive patients with groin hernia repaired by a single surgeon were prospectively recruited over 24 years. Pain scores were collected preoperatively and 30 days postoperatively – graded as none, mild, moderate or severe. Accident compensation status was collected. Differences in the percentage of patients with each grade of pain was then compared between ACC and non-ACC cases for preoperative pain, postoperative pain and pain score difference. Results 712 patients were included, 96 had accident compensation. ACC patients were more likely to have severe pain preoperatively compared with non-ACC (10.4% versus 4.5%, p = 0.003). 68.9% of ACC and 63% of non-ACC patients had improvement in their pain postoperatively, while 8.3% and 5.2% had deterioration in pain respectively; these differences were not statistically significant. There were no statistically significant differences in postoperative pain scores between the ACC and non-ACC groups. There was a positive association between preoperative and postoperative pain. Conclusion Accident compensation status was associated with significantly worse preoperative pain but not worse postoperative pain. The majority of ACC and non-ACC patients had improvement in pain postoperatively, while a small percentage experienced deterioration in pain.