The optimal operation technique for groin hernia repair has not been established. This study evaluates the long-term recurrence rate and perioperative complications after posterior inguinal mesh hernia repair using a gridiron incision described by Frans Ugahary. A retrospective analysis was performed of the medical records of 366 patients who underwent Ugahary hernia repair. Operative results and perioperative morbidity were evaluated retrospectively. Follow-up was done by clinical examination. The main outcome measure was recurrence rate at a mean follow-up of 2 years. Of the 386 groin hernia repairs, 263 hernia repairs were examinated in the outpatient clinic. The overall recurrence rate was 6.5% with a mean follow-up of 2 years, and 10.1% of the patients had minor complications. This retrospective study demonstrates that the repair according to Ugahary is a safe technique for operating on groin hernia. However, the procedure is difficult to reproduce in nonexpert hands. This technique must be compared to other inguinal hernia operation techniques in the near future.