Indirect inguinal hernia imposes a heavy patient caseload on surgical services in Africa. This study, conducted in rural southern Ghana in 1973, showed a marked increase in prevalence in adult males aged 55 years and older. In contrast, hospitalized patients undergoing herniorrhaphy in Accra were evenly distributed through all age groups. As hospital services expand and rural patients have better access to surgical care, recent innovations such as short stay surgery may be important for coping with rising patient demand.