Background: During the intrauterine life, the testis is located just below the developing kidney within the abdomen. As the testis descends through the inguinal canal and enters into the scrotal sac it is accompanied by a sac like extension of peritoneum known as the processus vaginalis. Once the testis descends completely into the scrotum, the processus vaginalis obliterates under normal circumstances but remains as a fibrous cord without any lumen. However, the most distal portion of it remains as tunica vaginalis sac around the testis with a potential space between the two layers of the sac, the visceral layer around the tunica albugenia of the testis and the parietal layer just beneath  the internal spermatic fascia of the scrotal layers. Under certain circumstances, the processus vaginalis does not obliterate and its patency persists. Depending upon its extent of patency and its communication with the peritoneal cavity various anomalies occur. I had an opportunity of working in various Armed Forces hospitals located all over India. As a surgeon I worked in the North- eastern region, western region and the southern region over a period of three decades. During that time I operated upon 778 children of various age groups with persistent processus vaginalis in various forms. In this article I will discuss about the incidence of various variations of processus vaginalis amongst Indian children. Methods: The various anomalies of the persistent processus vaginalis observed in the children who underwent surgery in different armed forces hospitals spread all over India, for the same were  recorded and analysed. Results: The commonest anomaly observed was communicating congenital hydrocele. The rare anomaly was encysted hydrocele of the cord. The other anomalies in order of frequency were congenital inguinal hernia, infantile hydrocele, funicular hydrocele and non-communicating congenital hydrocele. Conclusions: One can encounter all types of variations of persistent processus vaginalis with variable frequency in Indian children. 

Keywords: Processus Vaginalis; Congenital Inguinal Hernia; Congenital Hydrocele; Funicular Hydrocele; Infantile Hydrocele; Encysted Hydrocele of the Cord.