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Introduction. Inguinal hernia is a common surgical pathology in Nigeria but a giant (voluminous) recurrent strangulated inguino-scrotal hernia causing intestinal obstruction is very uncommon. Such a hernia, when it is recurrent and becomes complicated with strangulation and dynamic intestinal obstruction, presents many difficulties in management.  

Aim. To present the successful management of a case of a strangulated and obstructed giant recurrent inguinal hernia.

Description of the case. Here we present the case of 47 year old man who had intestinal resection and anastomosis with prolene mesh repair of the posterior wall for a strangulated recurrent large inguinal hernia using the technique of tension free sutured prolene mesh popularized by Lichtenstein. 

Conclusion. The patient recovered, was satisfied with his care and has been symptom free at 18 months of follow up. Giant recurrent hernias complicated by strangulated and intestinal obstruction are uncommon in Nigeria today, despite our resource-poor status. When they occur, tension free repair with sutured onlay prolene mesh after Lichtenstein, can be a useful and the best option with satisfactory results, as in the case reported.