A 68 year-old man with minimal past medical history presented with bilateral chronic groin pain after undergoing bilateral laparoscopic inguinal hernia repair 6 months prior. Tacks had been used for mesh fixation at that operation. On exam, he had no evidence of hernia recurrence, and nerve mapping demonstrated point tenderness along his inguinal crease bilaterally. Dynamic ultrasound demonstrated bilateral genitofemoral neuritis without nerve entrapment or hernia recurrence. Nerve injection with lidocaine produced about 48 hours of pain relief on the right side only. The decision was made to perform a selective, laparoscopic genitofemoral neurectomy on the right side due to his well-localized symptoms. He was taken to the OR where a Foley catheter was placed and ports were placed as though we were performing a standard laparoscopic transabdominal inguinal hernia repair. There was no evidence of recurrence. The peritoneum under the mesh was incised laterally and medially, and the peritoneal flap was retracted with dissection performed to access the preperitoneum. The psoas was identified with the genital and femoral branches of the genitofemoral nerve overlying it. These were dissected out, clipped using a standard clip applier, and cut with cold scissors. The peritoneal flap was then closed with a running, self-locking suture to avoid further use of tacks. Operative time was 79 minutes. The patient underwent nerve mapping in the PACU, which demonstrated numbness where he had previously experienced point tenderness, and was subsequently discharged. At 3-week follow-up, he had overall improvement of his symptoms.