Watchful waiting is safe for men with asymptomatic inguinal hernias, but data from randomized trials suggest that most men will ultimately undergo surgery, primarily because of pain. Watchful waiting is not recommended in women, given their higher prevalence of femoral hernias. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations. A 67-year-old man presents with a bulge in his right groin, which he recently noticed while in the shower. He is easily able to push it back completely, but it reappears intermittently. He says it is not painful and that he has not altered his activity level because of it. Physical examination confirms the presence of a right inguinal hernia. How should . . .