Objective: The aim of this comparative study is to compare the post-operative pain, postoperative complications, hospital stay and early return to normal activities in two groups of procedures, laparoscopic total extra peritoneal mesh repair and open Lichtenstein mesh repair for the treatment of inguinal hernia. Material and Method: This comparative study was conducted in the department of surgery, Liaquat University of Medical & Health Sciences, Jamshoro. 109 cases of inguinal hernia were collected from January 2007 to March 2008, were randomized in two groups, 52 for Laparoscopic total extra peritoneal mesh repair and 57 for Lichtenstein mesh repair. All patients of inguinal hernia were admitted throughout patient department. Children, patients with complicated inguinal hernia and those who are unfit for general anesthesia were excluded from study. Results: Majority of patients 53% belongs to age of 41 to 55years. Inguinoscrotal swelling was the commonest presentation. Cough impulse and reducibility was positive in 100% cases. Indirect inguinal hernia was 65% of cases and direct was in 35% of cases. Right sided hernia was also in 60% of cases and left sided hernia in 38 % of cases. Contents of sac were small intestine in 59 % of cases and omentum in 40 % of cases. Mean operative time was shorter in open mesh group 60 minutes than laparoscopic group 75 minutes. The mean analgesic requirement in laparoscopic group was three doses and in open group was 5 doses. The mean period of hospital stay was shorter in laparoscopic group i.e. 1.5 days than open group i.e 4.5 days. The mean period of resumption of daily life activities was 8.5 days in laparoscopic group and 21.5 days in open group. Conclusion: Laparoscopic herniorraphy is with less postoperative pain, early return to work and less hospital stay. Laparoscopic is best option of treatment for recurrent and bilateral hernias. Recurrence rate is more less because a large mesh is required for posterior repair. Cosmetic results are superior to that of open hernia repair.