Aim: To determine the demographic characteristics, clinical presentation, and management outcome of children treated for complicated inguinal hernia at a tertiary hospital in Enugu, Nigeria. Materials and methods: This was a retrospective analysis of children who were managed for complicated inguinal hernia. Results: Forty-eight cases of the complicated inguinal hernias had an emergency surgery during the study period. There were 34 males (70.8%) and 14 females (29.2%). The ages of the patients ranged from 1 month to 48 months, with a median age of 7.5 months. Sixty percent of the inguinal hernias were right sided and 40% were left sided. None was bilateral. The median time interval from the time of first clinic visit to incarceration was 6.5 months (range: 1–48). Twenty-one percent of the patients visited the clinic at least once before the incarceration. Pain over the inguinal swelling was present in all the patients. Surgical site infection (10.4%) was the most common postoperative complication. Mortality was 2.1%. Conclusion: Treatment of complicated inguinal hernia is associated with morbidity and mortality especially in developing countries due to late presentation. Clinical significance: The importance of early treatment of inguinal hernia in children to avoid complications that may arise.