The results of recurrent inguinal hernia repair in a prospective cohort study were evaluated. From May 1986 to December 1990 75 patients with 150 hernias (24 primary, 126 recurrent) were operated using a technique based on Stoppa's preperitoneal mesh repair (giant prosthetic reinforcement of the visceral sac; GPRVS). All patients were at high risk for recurrence: they all had bilateral hernias, mostly bilateral recurrent and often repeatedly recurrent. All patients had a physical examination 1 week, 6 weeks and 1 year after operation. Sixty patients (94 per cent of surviving patients) had a physical examination after a mean follow-up of 5.7 (range 4-9) years. There were no major complications. There was one deep infection that healed without removing the mesh. One of the 75 patients (1 per cent) had a recurrence 2 months after the operation, due to a technical failure. Because of the excellent results, the ease of the procedure and the low complication rate, GPRVS is the authors' operation of choice for any recurrent inguinal hernia.