This video presents a surgical repair of a large right-sided inguinal hernia in a one-year-old boy in Honduras. Emphasis is placed on the challenges posed by delayed presentation, including distorted anatomy and hypertrophied cremasteric fibers. The surgeon demonstrates a distal-to-proximal dissection technique to preserve cord structures and achieve high ligation at the internal ring. The procedure includes identification of anatomical landmarks, separation of hernia sac from the cord, and suture-based reinforcement. This instructional video offers valuable insights for pediatric surgeons in resource-limited settings.