In order to compare the effects of Bassini and tension-free mesh hioplasty, a total of 552 patients with inguinal hia who were subjected to surgical treatment in our hospital were randomly divided into the following two groups: the Bassini group (n = 269) and the tension-free mesh group (n = 283). The recurrence rates, pain, discomfort, and other complications were recorded, and the causes of the complications were explored. The recurrence rate in the Bassini group was 8.9% (24/269), significantly higher than that in the tension-free repair group (2.8%, 8/283). In addition, the recurrence rates in the Bassini and tension-free groups before 2004 were 12.6% and 5.6%,respectively, which were markedly higher than the rates after 2004 (5.3% and 0.7%, respectively). The rate of postoperative discomfort and pain within the first three months was higher in the Bassini group compared to the tensionfree group (25.7% vs 18.5%, respectively). However, there was no difference after three months in the rate of postoperative discomfort and pain, incidence of infection, or scrotal edema between the two groups. The average hospital stay in the Bassini group was longer than that in the tension-free repair group (7.6 ± 1.2 vs 4.5 ± 2.2 days,respectively), but the cost was lower (4518.0±510 vs 6221.3 ± 578 yuan, respectively). Thus, tension-free mesh hioplasty is indicated for most inguinal hia patients due to the low recurrence rate, rapid recovery time, and treatment success, but the traditional Bassini procedure has lower cost and other beneficial effects and is still suitable for some patients.