Complete androgen insensitivity is a rare X-linked disorder characterised by a female phenotype in a chromosomally male individual. It usually presents at puberty with primary amenorrhoea or as an inguinal mass in a female infant. Treatment includes bilateral orchidectomy and hormone replacement therapy. We present the case of a 31-year-old female with complete androgen insensitivity and a presumed inguinal hernia. We discuss the importance of early diagnosis, emphasise the consequences of misdiagnosis, and raise the question of whether such patients have been appropriately managed in the past.