Objective: To investigate the selection of laparoscopic surgical procedure for inguinal hernia repair. Methods: The clinical data of 162 patients (178 sides), who underwent totally extraperitoneal (TEP) repair or transabdominal preperitoneal (TAPP) inguinal heruia repair, between January 2004 and January 2008 in the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed. The clinical results such as the amount of intraoperative blood loss, operative time, time to passage of flatus, postoperative hospital stay, postoperative complications, recurrence rate and long-term chronic pain between the two groups were compared. Results: The general data of the two groups before operation were comparable (all P>0.05). There was no operative mortality and no serious postoperative complications occurred in any of the groups. The time to ambulation, early complications and length of hospital stay between the two groups had no statistical differences (all P>0.05), while the operative time and surgical success rate of recurrent inguinal hernia repair of TAPP group were significantly higher than those of TEP group (both P<0.05), and the time to passage of flatus of TEP group was less than that of TAPP group (P<0.05). Conclusion: Laparoscopic approaches for inguinal hernia repair are safe and each of the two procedures has its advantages and disadvantages. Thus, the choice of procedure may not be uniform and, instead, should depend on the patient’s individual condition and surgeon’s operative experience.