The ilioinguinal/iliohypogastric (II/IH) nerve block is a regional anaesthesia technique used for surgical and analgesic interventions in the inguinal region. These nerves originate from the L1 ventral ramus, with occasional contributions from T12 or L2, and travel between the transversus abdominis and internal oblique muscles before providing sensory innervation to the lower abdomen, groin, and upper thigh. This block is commonly performed for inguinal hernia repair, appendicectomy, and lower abdominal surgeries, including Pfannenstiel incisions. It is particularly beneficial in paediatric patients and those requiring opioid-sparing postoperative pain management. The technique can be performed using a landmark-based approach or ultrasound guidance. Ultrasound guidance allows real-time visualisation of the nerves and surrounding structures, ensuring safe local anaesthetic deposition, which enhances accuracy and reduces the risk of complications such as intravascular injection or bowel injury. While generally safe, potential complications include femoral nerve blockade leading to quadriceps weakness, vascular puncture, and local anaesthetic systemic toxicity (LAST). The II/IH block remains an effective technique for perioperative analgesia in lower abdominal surgeries.