Ilioinguinal neuralgia is a painful syndrome caused by compression or injury to the ilioinguinal nerve as it travels along its path.  The most common cause of injury is trauma to the area or injury to the nerve during surgery.  The symptoms of ilioinguinal neuralgia are numbness and burning in the lower abdomen that radiates to the groin or inner thigh.  The pain is worsened by assuming the upright position or bending backwards.  This puts traction on the nerve.  Weakness of the muscles of the abdominal wall may be present.  Treatment of ilioinguinal neuralgia begins with conservative modalities such as physical therapy or TENS.  Oral medications such as Gabapentin, Pregabalin and antidepressants such as amitryptyline are useful.  An ilioinguinal nerve block, with a dilute solution of a local anesthetic and a steroid, can markedly decrease the pain and improve quality of life.  Rarely, surgery to free up the nerve from compression can help.