Surgery is the only way to cure an inguinal hernia. There are many types of tension-free hernia repair, the most common being mesh-filled and flat-piece tension-free repair. What are the clinical outcomes and costs of the two procedures for inguinal hernia? It was found that there was no difference between the two groups in terms of postoperative complications scrotal effusion, postoperative chronic pain, and recurrence rate, and the postoperative foreign body sensation was higher in the mesh plug group than in the flat-piece group. The two groups of patients were compared in terms of surgery-related indexes and hospitalization time and cost. There was a difference between the two groups in terms of surgery time and in terms of average hospitalization cost. There was no difference between the two in the amount of surgical bleeding and the number of days of hospitalization. Tension-free hernia repair and the application of biological and artificial materials is a major innovation in hernia surgery and started in 1997 in China, and is the preferred procedure for inguinal hernia treatment. The mesh plug filled hernia repair is characterized by its tapered tip that allows targeted repair of the internal annular orifice and decomposes the abdominal pressure at the internal annular orifice by changing its orientation, thus removing the cause of hernia pathogenesis and achieving a reduction in recurrence. It is not required to fully free the anterior peritoneal space during surgery, thus reducing the occurrence of damage to the spermatic cord and abdominal wall vessels. The disadvantage is that intraoperative suturing of the conus is required, which increases the operative time, and also due to the increased amount of artificial material, the postoperative foreign body sensation is obvious, as also shown in the study by Xu Yangxian et al [7]. Our experience is that to reduce postoperative foreign body sensation, it is important to ensure that the outer edge of the cone is lower than the transverse abdominal fascia during surgery, and that the outer edge is approximately 1.0 cm from the inner annulus when suturing to avoid too close a stitch. The flat-piece tension-free repair is characterized by strengthening the posterior wall of the inguinal canal by repairing it, thereby removing the causative factor and reducing recurrence. This surgical method has fewer operational steps, and the flat sheet can be appropriately cut according to the patient’s body type and the degree of abdominal wall defect, which ensures the repair of the defect while achieving individualized and custom-made hernia repair surgery. However, the flat-piece repair has the advantages of simpler operation, less postoperative foreign body sensation and lower price than the mesh-filled repair, which is more suitable for clinical promotion.