Inguinal hernia most probably has been a disease ever since mankind existed. Their treatment was a challenge to many doctors throughout history. Today they are no longer considered life-threatening disease, but they are still frequent in the population. Most patients are men who, because of embryogenesis, have a predisposition for development of hernia. Hernia repair is the most common procedure performed in general surgery. Hernia repair has made progress throughout the history. The most significant improvement occurred in the late 19th century, when Eduardo Bassini described and applied his technique of reinforcing the posterior wall of the inguinal canal by triple stitching fascia and muscle tissues. His way of reconstruction resulted in a considerable tension between tissues and frequent recurrence as a result. The next breakthrough was the introduction of prosthetic materials in the reconstruction of the inguinal canal. Irving Lichtenstein is considered to be a pioneer of the tension-free repair by using prosthetic mesh. He used prosthetic material to bridge the gap in the wall of the inguinal canal. That removed a significant amount of tension between the tissues and reduced the recurrence rate. The last significant development was the introduction of laparoscopic techniques in surgery, which allows laparoscopic hernia repair. The ideal hernia repair technique should have a low recurrence rate with minimal complications and should be simple and inexpensive to perform. It should cause low discomfort to the patients and allow them a quick recovery. Tension-free repair proved to be the best choice of the currently available techniques. Compared with the tissue methods there are significantly lower recurrence rates, shorter duration of the surgical procedure, lower postoperative pain, shorter hospital stay and it is more cost effective. Compared to laparoscopic approach, in terms of recurrence rates there are similar results, but without using general anesthesia and expensive equipment, with a shorter duration of surgical procedure and fewer intraoperative complications, also the surgical technique is easier to learn and hospital costs are lower. Because of these advantages, tension-free repair is now considered to be a standard method of treatment for primary inguinal hernias.