Objective To observe the clinical effect of laparoscopic inguinal herniorrhaphy （LIH） on adult inguinal hernia. Methods A total of 86 cases of adult inguinal hernia were randomly divided into an observation group （n=43） and a control group （n=43）. The observation group received LIH, and the control group received open tension-free herniorrhaphy （OTH）. The operative indexes, postoperative recovery, hernia recurrence, and incidence of complications of the two groups were compared. Results The operation time of the observation group was significantly longer than that of the control group （P<0.05）. The amount of intraoperative blood loss, the application rate of postoperative analgesics, the time of hospitalization, and the incidence of postoperative complications in the observation group were lower than those in the control group （P<0.05）. There was no significant difference in recurrence rate between the two groups at follow-up visits after 6-12 months. Conclusion LIH is effective in the treatment of adult inguinal hernia, with faster postoperational recovery, less pain, and less complications.