Purpose: Elective repair for umbilical or epigastric hernia is a frequent minor surgical procedure. Several studies have demonstrated chronic pain after groin hernia repair but long-term complaints have been only scarcely studied. This study was undertaken to investigate long-term pain and discomfort after open repair for small umbilical or epigastric hernias. Methods: This is a retrospective study with prospective long-term follow-up. Only elective primary umbilical or epigastric hernias with an open mesh or sutured repair were included. A structured follow-up questionnaire was sent to all patients regarding verbal rating scores (VRS) of pain and discomfort (no, little, moderate, or severe) and recurrence. Patients with suspected recurrence were clinically examined. Results: There were 139 eligible patients, and 132 patients answered the questionnaire (95 % response rate). The median follow-up time was 36 months (range 15-85), and defect size was 1.0 cm (0.2-8.0). Sixteen patients reported moderate or severe pain and/or discomfort (12 %, 95 % confidence interval (CI): 6-18). The cumulated risk of recurrence was 11.5 %. Of the 15 patients with clinical recurrence or reoperation for recurrence, 5 patients reported moderate/severe complaints (31 %) whereas 11 of the remaining 116 patients with no recurrence (10 %) reported moderate/severe complaints (P = 0.014). Conclusion: Surprisingly, many patients complained about pain and discomfort 3 years after elective repair for a small umbilical or epigastric hernia.