Background: Inguino- scrotal swellings are the commonest surgical problems encountered in the paediatric age group. They are mostly diagnosed on clinical examination and sometimes by ultrasonography. They are usually treated by surgery with rarely any complications. Aim: The aim of the study was to evaluate the epidemiology, clinical presentation, management and complications of inguino-scrotal swellings in the paediatric age group. Methods: 130 patients under 14 years of age were included in this prospective study irrespective of gender. Patients were evaluated by clinical presentation, birth history, immunization, family history, blood and radiological investigations and the data was noted. Incidence of associated anomalies, treatment given and any complications were recorded. Results: Out of 130 patients, 116 were males and 14 were females with the ratio of 8.2:1. Right side was involved in 87 patients (67%) and left side in 35 patients (27%). 68 patients (52%) had inguinal hernia, 29 (22.3%) had hydrocele, 24 (19%) with undescended testis, 3 had testicular torsion and one each with ovarian mass, ovarian cyst, varicocele, inguinal abscess, retractile testis and epididymo-orchitis. 91 patients underwent herniotomy, 32 orchidopexy, 2 orchidectomy, 1 varicocelectomy, 1 incision drainage , 2 excision of mass, and 1 patient managed conservatively. No major post operative complications were seen except superficial wound infection in 3 patients. Conclusion: Inguinal hernias more commonly occur on the right side due to a delay in the descent of the right testis. Congenital hydrocele can be observed till the age of one year for spontaneous involution while hernias should be treated as soon as possible. Herniotomy is a safe and effective procedure.