【Abstract】 Objective To investigate the efficacy and safety of tensionfree inguinal hernia repair with mesh plug (with Rutkow as an example) and tensionfree repair of preperitoneal space with the middle incision of lower abdomen (with Kugel as an example). Methods 130 patients with inguinal hernia admitted in our hospital from November 2012 to November 2015 were selected and divided into two groups according to the way of operation. All patients were given the same standardized treatment procedure. The two groups were respectively treated with Rutkow and Kugel methods. The operation, postoperative complications, postoperative pain scores (VAS) and postoperative recurrence rates were recorded and compared between the two groups. Results There were no statistical difference of operation time, postoperative hospital stay, ambulation time and postoperative recovery time between the two group (P＞005). The total incidence of postoperative complications in Kugel group was significantly lower than that in Rutkow group (P＜001). The two groups did not leave any obvious sequelae after the positive symptomatic treatment. The scores of VAS in the Kugel group were significantly lower than those in the Rutkow group at each stage after operation (P＜001). There were 2 cases of recurrence in Rutkow group, but there was no recurrence in Kugel group. Conclusion The repair surgery of the tensionfree repair of preperitoneal space with Kugel as an example can effectively reduce the postoperative pain, complication rate and recurrence rate. It does not need more operative time and postoperative recovery time.