Preventing chronic pain is a major concern in the management of inguinal hernia and may be considered the most important clinical outcome, as recurrence rates have decreased, and pain has become the more common and significant complication. Understanding the causative mechanisms and risk factors of chronic postoperative inguinal pain (CPIP) is essential for preventing, diagnosing, and treating this condition. Interdisciplinary diagnostics and a multidisciplinary team are recommended for treating patients with CPIP. First-line treatments should include drug therapies as well as diagnostic and therapeutic nerve blocks. A tailored approach to neurectomy, with or without mesh removal, will be necessary depending on the primary surgical method. The decision on the type of neurectomy—selective or triple—should be left to the discretion of the experienced surgeon. Detailed knowledge of risk factors, meticulous surgical technique with profound anatomical knowledge, proper nerve identification and handling, and careful mesh fixation are of utmost importance for the prevention of CPIP.