Purpose Bladder hernia is an uncommon clinical entity that is most often described in isolated case reports and small case series. Consequently, current understanding of its presentation, diagnostic evaluation, operative management, and associated complications is derived largely from descriptive literature. This systematic review collates published case-based reports to summarise clinical presentation, imaging findings, operative management, and reported complications of bladder hernia across different clinical settings. Methodology A qualitative systematic review was undertaken using papers identified through searches of PubMed, MEDLINE, and EMBASE. Reports describing individual case reports or small case series of bladder hernia were included. Relevant data were extracted from the published literature and synthesised narratively. Results The available literature consisted predominantly of single-patient case reports and small case series. Common presenting features included inguinal or inguinoscrotal swelling, frequently accompanied by lower urinary tract symptoms. Acute presentations such as urinary retention, incarceration, urosepsis, and renal impairment or obstructive uropathy were also described. Computed tomography was the most frequently utilised imaging modality and was commonly used to confirm the diagnosis and assist with preoperative planning. Other imaging techniques included ultrasound and cystogram. Operative management strategies varied and included laparoscopic approaches, such as transabdominal preperitoneal and totally extraperitoneal repair, as well as open surgical techniques. Conclusion Although presentation and management varied, recurring features included characteristic clinical findings, frequent reliance on computed tomography for diagnosis, and a range of operative approaches. Synthesis of case-based evidence provides useful diagnostic and peri-operative insights that may assist clinicians in recognising bladder hernia and informing surgical decision-making in the absence of higher-level evidence.