Aims: The primary aim of this prospective study was to investigate the accuracy of groin ultrasound in the detection of inguinal hernia. Secondary outcomes included the rate of ultrasound ordering prior to surgeon review and to assess the accuracy of groin ultrasound in correctly identifying the type of inguinal hernia. Methods: This study was a prospective analysis involving 82 consecutive patients who underwent inguinal hernia repair. We calculated the percentage of patients who had an ultrasound done prior to surgeon review, and the correlation of ultrasound findings to operative findings. Results: 82 patients with clinically detectable inguinal hernias underwent surgical repair. 58 (70%) had imaging prior to review by the surgeon, 53 (91%) of which were ultrasounds. In patients who had an ultrasound done preoperatively, ultrasound correctly identified the presence of any type of hernias in 44 (83%) patients. In the remaining 9 (17%) patients, there were 6 spermatic cord lipomas and 3 wide deep rings with preperitoneal fat, all of which were reported as indirect inguinal hernias on ultrasound. Conclusions: Despite the fact that inguinal hernia is a clinical diagnosis, 70% of our patients had imaging prior to surgeon review. In our study, we found ultrasound had an accuracy of 83% in the diagnosis of inguinal hernia. If we use the European Hernia Society (EHS) groin hernia classification, the accuracy is 100%.