Objective: To evaluate the safety and efficacy of tension-free herniorrhaphy in treatment of incarcerated inguinal hernia. Methods: The clinical data of 60 patients with incarcerated inguinal hernia undergoing surgical treatment during January 2013 to December 2014 were retrospectively analyzed. Of the patients, 32 cases underwent tension-free herniorrhaphy with mesh-plug technique (observation group), and 28 cases underwent traditional herniorrhaphy (control group). The main clinical variables between the two groups of patients were compared. Results: The preoperative data of the two groups of patients were comparable. The operative time (53.6 min vs. 51.8 min) and intraoperative blood loss (10.3 mL vs. 11.1 mL) showed no statistical difference between observation group and control group (both P>0.05); postoperative complications occurred in 9 cases (28.1%) in observation group and in 5 cases (17.9%) in control group, which showed no statistical difference (P>0.05); no mesh infection occurred in observation group; the average length of hospital stay in observation group was significantly shorter than that in control group (5.3 d vs. 6.3 d, P<0.05). Follow-up was conducted for 24 to 36 months in both groups, and recurrence occurred in no case in the study group but in 5 cases in control group, and the difference was statistically significant (χ2=4.12, P<0.05). Conclusion: For incarcerated inguinal hernia, tension-free herniorrhaphy can shorten the length of hospitalization and reduce postoperative recurrence, and is safe and effective.