Summary The importance of freeing an indirect inguinal hernial sac or a peritoneal protrusion at the internal ring is discussed and emphasized. The technic at the internal ring used at the Shouldice Clinic is described. The justification for this technic lies in the results obtained. An analysis of more than 32,000 inguinal herniorrhaphies performed in this hospital between 1945 and 1961 is given, including more than 2,600 recurrent inguinal herniorrhaphies and 2,200 sliding inguinal herniorrhaphies. In patients operated upon for an indirect inguinal hernia, a very low recurrence rate was achieved.