Abstract：Objective To compare the clinical efficacy of laparoscopic transabdominal and open preperitoneal inguinal hernia repair. Methods According to the patients?? cardiopulmonary function and willingness, 62 patients with inguinal hernia were divided into control group and experimental group, with 31 patients in each group. The patients in the control group were underwent open peritoneal inguinal hernia repair, and in the experimental group were treated with laparoscopic transperitoneal inguinal hernia repair（TAPP）. The stress response, pain, complication rate and postoperative recovery of the two groups were compared. Results After operation, the tumor necrosis factor alpha, cortisol and pain scores and the incidence of complications in the experimental group were lower than those in the control group, the incision pain, bed-out, venting and hospitalization were shorter than those in the control group, the differences of all index between two groups were statistically significant（all P＜0.05）. Conclusion Compared with open preperitoneal inguinal hernia repair, laparoscopic TAPP has less stress response and postoperative pain, fewer complications, shorter postoperative recovery time and higher clinical application value.