Inguinal hernia is a more common condition and for adults, medication is ineffective and the only cure is surgery. The current mainstream is a tension-free repair using a patch as opposed to the previous broken suture approach. This approach has replaced traditional repair because of its low recurrence rate of less than 1% and the lack of significant postoperative discomfort in patients, and is now widely used as a tension-free repair using a patch. The common procedures include open and laparoscopic inguinal hernia repair, how can one choose wisely? This is briefly described below. This approach is known as “open” and can be done under local anesthesia. Our incision length is about 100px, which is significantly smaller than the traditional incision of 7-200px. The amount of bleeding can be controlled within 1-2ml, and there is basically no bleeding. We can achieve discharge within 24 hours after surgery, which means that you can operate today and go home tomorrow, and you do not need special treatment after surgery, only rest. The advantages of this method are that local anesthesia is sufficient, the traumatic surface in the body is small, the operation is minimally invasive, and the range of indications is wide, which is suitable for most people, especially the elderly. Laparoscopic hernia repair is a so-called “minimally invasive” procedure that requires general anesthesia, but it may not be truly minimally invasive. Laparoscopic surgery is performed by making three small 0.5-25 px holes in the stomach under direct machine vision, which allows for more precise operation, less trauma to the abdominal wall and spermatic cord, and less potential for nerve damage. Because the patch is repaired from the inside out, there is less pressure on the human abdominal wall compared to open surgery, resulting in a lower recurrence rate, and the patient usually resumes daily physical activity sooner after surgery than with open surgery, usually being able to exercise after two weeks. Also, laparoscopy is very suitable for bilateral and recurrent hernias. The three holes made by laparoscopy are capable of performing both sides of the surgery at the same time, which is not the case with open surgery. In patients with recurrent hernias, the structures at the site of the first surgery have already been damaged and an open surgery may cause side injuries, which laparoscopy can reduce. In addition, laparoscopy is an alternative cosmetic approach for those patients who require no scarring. Despite all the advantages of laparoscopy, it is not suitable for all patients and is not a strictly minimally invasive procedure. Because the knife is not dropped directly on the affected area and the surgical path is longer, laparoscopy creates a larger free traumatic surface in the body and the potential risk of surgery is higher than open, so the surgeon has to individualize the operation according to the patient’s actual condition. Laparoscopy with general anesthesia is not suitable for some elderly patients, especially those with more severe combined cardiopulmonary disease. In addition, the cost of laparoscopy is relatively high. Overall, both open and laparoscopic procedures are currently internationally accepted and widely used treatments. The former is simple and quick, has a small traumatic surface, is economical, and local anesthesia expands the range of surgical indications; the latter is suitable for bilateral or recurrent hernias, and the patient has less pain and faster recovery after surgery, but the potential risks of surgery are higher, and it is used with caution in people with cardiopulmonary disease and is more expensive.