It is estimated that over 70,000 hernia procedures were performed in Australia and New Zealand in 2023. It is also estimated that over 1,000,000 hernia procedures are performed annually worldwide. The substantial cost to the community and the healthcare system in treating this condition cannot be overstated. It is also accepted that a proportion of that cost is attributable to diagnostic investigations and subsequent surgical procedures which are considered of low value. The need to ensure that high value hernia surgery is delivered to patients is examined in this session. More importantly, the need to avoid low value investigation and procedures in an ever-increasing resource constrained clinical environment is discussed.