Once an adult has an inguinal hernia, there is generally no possibility of self-healing. Some conservative treatments, such as hernia braces or hernia belt compression therapy, have limited effectiveness and are inconvenient for long-term use; non-surgical treatments, such as local injections, clearly lack a strong theoretical basis and clinical evidence to support them. Surgery remains the only effective means to cure inguinal hernia. There are many surgical options for inguinal hernias, and even for a clinician who specializes in the treatment of hernias, one has to carefully consider and then choose when performing surgical treatment for a specific patient. Currently, there is no so-called “standard” or “golden procedure” for the surgical treatment of inguinal hernias that is strictly applicable to all patients. In fact, there are advantages and disadvantages to each of the available surgical approaches. Therefore, a mature and experienced clinical hernia surgeon will involve the patient and family in the selection of the surgical approach, and some knowledge of this aspect as a patient or family member will undoubtedly play a positive role in the rational selection of the surgical approach. The existing surgical methods for inguinal hernia are really diverse, ranging from traditional hernia repair to “tension-free” hernia repair, which has been emerging in recent decades, and various types of laparoscopic hernia repair have emerged by combining tension-free hernia repair with laparoscopic technology. The advantages and disadvantages of the various surgical procedures are now analyzed in the light of my clinical experience over the years, with a view to helping non-medical professionals in choosing the surgical procedure for inguinal hernia. I. Traditional inguinal hernia repair: All traditional repair methods are “tensioned” compared to the various “tension-free” hernia repair methods that are widely performed today. Therefore, most scholars agree that the recurrence rate of hernias is higher after traditional surgery than after “tension-free” hernia repair. In addition, because of the presence of tension, local pain is significantly worse in the short postoperative period than in the “tension-free” approach, and the return to freedom of movement after surgery is delayed. These are two of the main reasons why “tension-free” hernia repair is being strongly advocated in clinical practice. However, the traditional surgical approach does not require artificial or biological patches, and therefore avoids the potential disadvantages of using patches. The disadvantages of using hernia patches are not yet clear, but at least a few are certain: 1) increased cost of treatment, with patches currently costing more than $1000 and up to $5000-$6000; 2) increased chance of infection, which can complicate treatment and possibly lead to surgical failure; 3) although the use of patches can reduce the chance of recurrence, once recurrence occurs, the next surgery becomes unsuccessful. However, once recurrence occurs, the next surgery becomes relatively complicated, while it is relatively much easier to deal with recurrence in patients with traditional surgical methods. Based on the above understanding, it can be argued that the traditional surgical approach is still an option in the treatment of inguinal hernia and has some benefits. For patients with financial constraints, it can be considered as an option. II. Tension-free hernia repair modality (open): There are many surgical modalities for tension-free hernia repair, but a common denominator is the need to use a patch. The disadvantages are listed above, but the benefits are obvious: 1) compared with the traditional procedure, postoperative pain is significantly reduced, and the patient can get out of bed within a short time after surgery and the hospital stay is significantly shortened; 2) according to the current statistics, the recurrence rate is significantly lower after tension-free hernia repair. Based on these two points, tension-free hernia repair has become the mainstream of inguinal hernia treatment and is widely performed in hospitals at all levels. Tension-free hernia repair is subdivided into: 1) surgical approaches to strengthen the posterior wall of the inguinal canal: e.g., simple flat patch repair (Lichtenstein and Trabucco) and mesh plug plus flat patch (Rutkow and Millikan) approaches; 2) tension-free repair of the anterior peritoneal space, e.g., Kugel, Gilbert and Stoppa repair approaches. It is undoubtedly difficult for a layperson to figure out these surgical approaches, but a little knowledge is certainly helpful in the choice of surgical approach. Laparoscopic inguinal hernia repair: This procedure is subdivided into three types: 1) preperitoneal repair via the extraperitoneal route (TEP); 2) transperitoneal preperitoneal repair (TAPP); and 3) intraperitoneal patch repair (IPOM). The first two are currently used more frequently, while IPOM was used more in the early days when laparoscopic hernia repair was performed and is now rarely used. It is impossible for a layman to understand these three surgical modalities very well, but in fact there is no big difference between the first two modalities, which are widely used today, and as long as they are performed correctly, they can achieve the same ideal treatment results. Laparoscopic hernia repair is the product of the combination of tension-free hernia repair and laparoscopic technique, which also requires the use of a patch and therefore inherits almost all the advantages and disadvantages of the general tension-free hernia repair compared to the traditional procedure. However, it is less invasive and has a faster postoperative recovery than the usual tension-free hernia repair, although it requires general anesthesia, which makes it significantly more expensive to treat, and it is not indicated for patients with cardiopulmonary insufficiency that contraindicates general anesthesia. For recurrent inguinal hernias, laparoscopic hernia repair may be the preferred modality, regardless of whether a patch has been used previously. Overall, regardless of the form of inguinal hernia repair, with proper selection, good outcomes can be achieved when used to treat inguinal hernias. Therefore, different patients can make a reasonable choice according to their economic status under the guidance of their clinicians.