Background: We sought to determine perioperative variables predictive of complications or recurrence for patients undergoing surgical repair of inguinal hernias. Patients and Methods: Using data from the Veterans Affairs trial, regression analyses were utilized to identify perioperative factors significantly associated with complications (overall, short-term and long-term), long-term pain, and to develop a risk model for recurrence. Results: Recurrent and scrotal hernias were predictors for short term and overall complications, regardless of technique. Older age and higher Mental Component Score of the SF-36 were associated with higher risk of long term complications in the open group while prostatism and increased body mass index were the significant predictors in the laparoscopic group. Long-term pain complaints decreased as patient age increased in both groups. Patient and surgeon factors were predictive of recurrence but varied greatly depending on surgical technique. Conclusions: Regardless of technique, scrotal and recurrent hernias were associated with a greater risk of complications and younger patients had more long-term pain. Predictors of recurrence vary based on surgical technique.