Abstract
A male patient in his seventh decade underwent elective open right inguinal hernia repair. Intraoperatively, we discovered complete spermatic cord duplication—two separate structures, each containing a vas deferens and neurovascular bundle. The hernia repair was successfully completed with careful preservation of both cord structures. To our knowledge, this represents the first reported case of true complete spermatic cord duplication encountered during open inguinal hernia repair. Postoperative ultrasonography confirmed anatomical duplication and vascular patency. This case highlights a critical anatomical variant that demands intraoperative recognition and modified surgical technique to prevent iatrogenic injury and testicular ischaemia, providing a clear management strategy for this rare anomaly.