Hernias are extremely common. Globally, about 14.6 million people are living with an inguinal, femoral, or abdominal hernia at any given time, and more than 1 million hernia repairs are performed each year in the United States alone. But “hernia” is a broad category, and the likelihood of developing one depends heavily on the type, your sex, your age, and your surgical history.
Inguinal Hernias: The Most Common Type
Inguinal hernias, which occur in the groin area, account for the majority of all hernias. The lifetime risk for men is roughly 27%, meaning more than one in four men will develop one at some point. For women, the lifetime risk drops to about 3%. This enormous gap exists because of anatomy: the inguinal canal, where the spermatic cord passes through the abdominal wall in men, creates a natural weak spot that tissue or intestine can push through.
Globally, the prevalence rate in 2021 was about 295 per 100,000 in males compared to 114 per 100,000 in females. Interestingly, while the rate per person has actually decreased by about 23% over the past three decades (likely due to fewer physically demanding jobs and better surgical techniques), the total number of cases has climbed from 12.2 million to 14.6 million simply because the world’s population is larger and older.
Femoral Hernias and Why Sex Matters
Femoral hernias develop just below the groin crease, near the upper thigh. They’re far less common overall, making up only about 1.8% of all groin hernia repairs. But the distribution is strikingly lopsided. In women, femoral hernias represent 17 to 37% of all groin hernias, depending on how they’re detected. In men, the figure is under 3%. When surgeons use camera-assisted techniques that allow a more thorough look at the groin from the inside, the detection rate in women climbs as high as 37%, suggesting many femoral hernias in women go undiagnosed with standard examination alone.
This matters because femoral hernias carry a higher risk of becoming trapped or strangulated, cutting off blood supply to the tissue inside. They’re less common than inguinal hernias but more likely to become surgical emergencies.
Umbilical Hernias in Newborns
Umbilical hernias are remarkably common in babies. Between 15% and 23% of all newborns in the United States have one, which translates to roughly 800,000 infants per year. These appear as a soft bulge near the belly button where the abdominal wall hasn’t fully closed around the umbilical cord site.
The reassuring part: over 90% of these hernias close on their own by age 5 without any treatment. Surgery is typically only considered if the hernia persists past that age or causes symptoms. For most parents, it’s a waiting game that resolves without intervention.
Hiatal Hernias Get More Common With Age
Hiatal hernias, where part of the stomach pushes up through the diaphragm into the chest cavity, follow a dramatically age-dependent pattern. In one cross-sectional study, only 10% of people between ages 14 and 24 had one. That number jumped to 43% in people aged 25 to 54 and reached 64% in people between 55 and 64. The connective tissue around the opening in the diaphragm weakens over time, which explains the steep climb.
Many hiatal hernias produce no symptoms at all. When they do, the most common complaint is acid reflux, since the displaced stomach allows acid to flow back into the esophagus more easily. The high prevalence in older adults means that if you’re over 50 and experience frequent heartburn, a hiatal hernia is one of the more likely contributors.
Incisional Hernias After Surgery
If you’ve had abdominal surgery, particularly through a vertical midline incision, you have a meaningful chance of developing a hernia at the scar site. Estimates range from 2% to 20% of all abdominal wall closures, though the number is thought to be commonly underestimated. One controlled trial found that 14.5% of patients developed an incisional hernia after a midline incision, compared to just 1.7% after a horizontal (transverse) incision.
This is one reason surgeons increasingly prefer horizontal or smaller incisions when the procedure allows it. The orientation of the cut matters because a vertical incision runs against the natural pull of the abdominal muscles, putting more tension on the healing wound.
Many Hernias Go Undetected
A surprising number of hernias exist without anyone knowing. Up to 15.2% of hernias are discovered incidentally on imaging done for completely unrelated reasons, like a CT scan for kidney stones or a routine ultrasound. One study that performed abdominal wall ultrasounds on 302 patients referred for other issues found that about 24% of women and 23% of men had a paraumbilical hernia they didn’t know about. Separately, reviews of CT scans taken for unrelated purposes found a type of diaphragmatic hernia (Bochdalek hernia) in 10.5% to 12.7% of adults.
These silent hernias rarely cause problems and may never need treatment. But they do mean that official prevalence numbers almost certainly undercount the true frequency of hernias in the general population.
Who’s at Higher Risk
Beyond sex and age, the strongest modifiable risk factor is body weight. Having a BMI above 30 roughly doubles the probability of developing an abdominal hernia. Excess weight increases the pressure inside the abdominal cavity, pushing tissue outward through any weak point in the muscle wall. This applies to inguinal, umbilical, and incisional hernias alike.
Other well-established risk factors include chronic coughing (from smoking or lung disease), chronic constipation with straining, heavy lifting as part of daily work, and a family history of hernias. Connective tissue disorders that weaken the structural integrity of the abdominal wall also increase risk, though these are less common. For incisional hernias specifically, wound infections after surgery, obesity at the time of the operation, and the use of midline incisions are the primary drivers.
Recurrence After Repair
If you’ve already had a hernia repaired, the chance of it coming back depends largely on the technique used. A 2014 meta-analysis published in JAMA Surgery compared mesh repairs (where a synthetic patch reinforces the weak area) with suture-only repairs (where the tissue is simply stitched back together). Mesh repairs had a recurrence rate of 2.7%, while suture repairs came in at 8.2%, roughly three times higher. This is why mesh has become the standard approach for most hernia types, though suture repair still has a role in certain situations, particularly for very small hernias or when mesh isn’t appropriate.
Even with mesh, recurrence isn’t zero. Factors like obesity, smoking, infection at the repair site, and returning to heavy physical activity too soon can all increase the odds of a hernia reappearing. Keeping your weight in a healthy range and allowing full recovery time after surgery are the most practical things you can do to lower that risk.