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Clinical question: Should routine contralateral inguinal region exploration be done to prevent a metachronous contralateral pediatric inguinal hernia? Results: The incidence of a metachronous contralateral pediatric inguinal hernia is 6.4 % in both genders. Sixteen contralateral groin explorations need to be done to prevent one metachronous contralateral pediatric inguinal hernia. Implementation: • Routine exploration of the asymptomatic contralateral groin is not recommended. • Infants less than one month old with an inguinal hernia should receive immediate specialist referral. • Older infants and children with a reducible hernia should be referred to the pediatric surgical outpatient department. • Pediatric patients with an original left-sided hernia or who were less than six months old at the time of the first hernia repair should receive regular follow-up in the primary health care setting