OBJECTIVE To compare the effects of mesh-plug and polypropylene hernia system (PHS) tension-free hernioplasty so as to explore the strategy of treatment for different patients. METHODS Eighty patients with inguinal hernia were assigned into 3 equal groups according to the randomization schedule: PHS group and mesh-plug group. The operating time and the outcomes were recorded. RESULTS The operating times of the mesh-plug group was 73.8 minutes significantly longer than that of the PHS group (56.5 minutes, P < 0.05). There was no significant difference in the recovery progress between these 2 groups. The numbers of patients who had sense of foreign body and numbness in the mesh-plug group were significantly greater than those in the PHS group (both P < 0.05). CONCLUSIONS Mesh-plug tension-free hernioplasty is indicated for most inguinal hernia patients owing to the simple operation. More rational in design and more effective in reduction of recurrence, PHS is suitable for thin patients or patients with week or large transversalis fascia defection. And PHS is able to reduce the postoperative discomfort.