This paper provides a detailed analysis of a case of bilateral inguinal hernia combined with cryptorchidism. The patient is 59 years old, with a social gender of "female," and was admitted for bilateral inguinal hernia treatment, undergoing laparoscopic trans-abdominal preperitoneal hernia repair. During the surgery, bilateral inguinal masses were identified, and postoperative pathology confirmed cryptorchidism. Further examination revealed a congenital absence of the uterus and adnexa. The patient exhibited well-developed female breasts (E-cup) and adult female vulvar characteristics. By comprehensively elaborating the clinical features, diagnostic and treatment process, various examination results, and in-depth discussion of this case, this study provides valuable reference for clinicians when dealing with complex disorders of sex development and hernia-related conditions, thereby enhancing the understanding and management of such rare diseases.