The case-notes of 189 athletes with chronic groin pain were reviewed to determine the prevalence of the underlying conditions. Diagnoses were determined following a review of their history, clinical examination, local anaesthetic infiltration, radiological investigation, surgical exploration and clinical progress. The most common pathology found was an incipient hernia (50% of cases). Twenty-seven percent were found to have multiple pathologies. An approach to the differential diagnosis and radiological investigation of athletes with chronic groin pain is suggested.