This is a prospective study involving 50 cases of unilateral inguinal hernia admitted in Yenepoya Medical College, Mangalore, Karnataka, India, 25 of whom underwent open Lichtenstein’s repair and the remaining, laparoscopic Total Extraperitoneal (TEP) Repair. The study deals with a comparison of the effectiveness of these two types of repair. 50 cases of unilateral inguinal hernia admitted in Yenepoya Medical College, Mangalore, were selected on the basis of convenience sampling method. Adults (>15 years) consenting for randomized trials and having either unilateral direct or indirect inguinal hernia were included. They were randomly chosen for Lichtenstein’s or TEP repair and the results were compared on the basis of the following outcome measures :i) duration of operation (in mins), ii) post operative pain ( in days), iii) length of hospital stay ( in days), iv) post operative complications like haematoma, seroma, v) time to return to usual activities and vi) cost comparison . The outcomes were evaluated and compared with standard published literature. The mean duration of surgery for Lichtenstein’s repair was 62.2 minutes whereas for TEP was 72.4 minutes. Duration of post operative pain was more (2.8 days) for open repair than 1.48 days for TEP repair; same being for post operative stay (5.12 days for Lichtenstein’s repair and 2.6 for TEP). Time of returning to normal work was 43.72 days for Lichtenstein’s repair and 25.6 days for TEP repair. However, TEP repair was approximately Rs 5000 more expensive and had more post operative complications. TEP repair, though expensive, is superior with regard to reduced post operative pain, reduced hospital stay and early return to normal activity, when compared to Lichtenstein’s repair.