Abstract: Objective To explore the clinical effect of tension-free herniorrhaphy in the elderly patients with inguinal hernia. Methods The clinical data of 90 elderly patients with inguinal hernia were analyzed retrospectively, and they were divided into two groups according to different surgical treatment methods. The patients who were treated with traditional hernia repair were selected as control group(n=45), those who were treated with tension-free hernia repair were selected as study group(n=45), and the surgical indexes, incidence of complications and 1-year recurrence rate between the two groups were analyzed. Results The operation time, bed-off time and hospitalization time of the study group were significantly shorter than those of the control group(P<0.05), while 24 h Visual Analogue Scale(VAS)score after operation was significantly lower than that of the control group(P<0.05); the incidence of complications and recurrence rate of inguinal hernia in the study group were significantly lower than those of the control group(P<0.05). Conclusion The tension-free hernia repair for the elderly inguinal hernia has a significant clinical efficacy, with the advantages of simple operation, quick recovery and mild pain, and can reduce perioperative complications and the recurrence rate.