Background <p>Herniation of female genital organs complicated by Mayer–Rokitansky–Küster–Hauser syndrome in adolescents is rarely reported in previous studies, and delayed diagnosis or misdiagnosis of this situation can lead to serious injury.</p> Case presentation <p>Herein, we report a 13-year-old Chinese female patient who presented with a recurrent left inguinal mass. The patient was diagnosed with herniation of the uterus, ovaries, and fallopian tubes into the inguinal canal complicated by adolescent Mayer–Rokitansky–Küster–Hauser syndrome. We provide anatomic, diagnostic, and therapeutic considerations for this rare phenomenon. The malformed uterus, ovaries, and fallopian tubes were returned to the abdominal cavity using the Bassini technique for inguinal hernia. No intraoperative or postoperative complications were reported, and the patient made a good postoperative recovery.</p> Conclusion <p>This study highlights the coexistence of Mayer–Rokitansky–Küster–Hauser syndrome with inguinal hernia. Early and accurate diagnosis is crucial for successful intervention. Individualized surgical and follow-up strategies play a key role in optimizing both physical and mental recovery.</p>