Background: Anterior cutaneous nerve entrapment syndrome (ACNES) is often-overlooked as a cause of chronic abdominal pain (CAP)1. Compression of cutaneous T7-T12 neurovascular bundles through oedema, scarring or iatrogenic insult precipitates this pain pathology observed in 0.05% of the general population (1). Blind-trigger points, rectus sheath blocks and targeted ultrasound injections traditionally form the mainstay of temporary management. We report on a retrospective cohort of 10 patients undergoing neurectomy as a novel, emerging definitive treatment of ACNES. Method: 34 adult patients with clinically and radiologically diagnosed ACNES were included in this retrospective study. Ten patients (29.4% of the cohort) underwent surgical neurectomy. Brief-Pain-Inventory(BPI), European Quality-of-Life-5-Dimensions(EQ-5D-5L) and Patient-Global-Impression of Change(PGIC) were collected. Percentage and duration of pain-relief, complications and limitation scores were recorded. Findings: 60% of surgical patients reported 81-100% pain-relief, 30% reported 50-80% relief, and 10% reported <50% relief. Pain-relief was generally durable: 40% of surgical patients (4/10) remained pain-free at >4 years, 20% were pain-free at 1-2 years, 10% at 3 years, and 30% at just 1 year. The mean pain score (0-10 scale) fell from 8.6 pre-operatively to 2.6 post operative (mean-improvement 6.0), and the mean activity limitation score fell from 7.4 to 2.4 (mean-improvement 5.0). Scores for non-surgical patients were not formally. 70% of surgical patients had no complications. Conclusion: Surgical neurectomy, as a single-time intervention with low morbidity portends high-rates of improvement with durable pain relief. Further research is required to investigate selection criteria for patients undergoing surgical versus other management options for this complex and debilitating pathology.