The usual manifestations of meconium peritonitis confined to the inguinciscrotal region are soft hydroceles, hard nodules in the scrotum. and, occasionally, calcified nodules in the wall of a hernia sac. with or without calcification on abdominal X-ray. Inguinal hernia is an extremely rare manifestation of healed meconium peritonitis. An unusual presentation of meconium peritonitis encountered during hernia repair is described herein to alert the pediatric surgeon of this possibility to avoid unnecessary abdominal exploration.