The aim of this study was to document clinical features of inguinal hernia (IH) in the pediatric populace. It delivers data to assess related risk factors of incarcerated hernia, its reappearance in addition to the occurrence of contra lateral metachronous hernia. Materials and Methods: We report a retrospective analytic study comprising 230 children presenting with IH and operated from April 2015 to June 2017 in the pediatric surgery department, King Abdulaziz Hospital. Results: We managed 36 girls (15.6%) and 194 boys (84.4%). The mean age was 3 years; The median age in the studied group was 3 years (range 22 days to 12 years). Males were predominantly affected (84.4%, n = 194). The rate of IH was more important in the youngest group (age < 2 years); thus, we accounted 43.5% (n = 100) infants. The cumulative incidence of hernia in the 2-6-year age group was 34.7% (n = 80). Thirteen percent (n = 31) of these patients presented with an incarceration mostly on the right side (62.6%, n = 154). We recognized that the total rate of incarcerated hernia incidence in premature group was evaluated at 27%. This rate was high, particularly in neonates and infants. Prematurity and hypotrophy were documented in 9% and 7% respectively. The mean follow-up period was 3.8 years. We think that incarceration can be related to several risk factors such as feminine gender, prematurity, and the initial left side surgical repair of the hernia. Conclusion: IH occurs mainly in male infants. Prematurity and male gender was identified as risk factors of incarceration. Contralateral metachronous hernia was reported, especially in female infants and after a left side surgical repair of the hernia.