HighlightsGiant inguinoscrotal hernias are a rare entity in modern clinical practice mainly because of the patient’s neglect.Our patient had a type II giant inguinoscrotal hernia extending below the midline between mid-inner thigh and suprapatellar bone lines.We avoided preoperative or intraoperative procedures for the lengthening of the abdominal wall.Despite the longevity and size of the hernia, we avoided a debulking procedure, instead we performed a lower midline incision and connected it with an extended right inguinal incision.Patient’s recovery was uneventful with no complications or signs of recurrence at 6 month follow up.