〔Abstract〕 Objective To analyze the effect of tension-free repair in elderly inguinal hernia. Methods 84 elderly patients with inguinal hernia treated in The First Affiliated Hospital of Henan University of Technology from November 2018 to November 2019 were selected, and divided into control group and observation group, with 42 cases in each group, according to different treatment methods. The control group was treated with routine hernia repair, and the observation group was treated with tension-free repair. The therapeutic effects of the two groups were compared. Results The operation time, postoperative out of bed time and hospital stay in the observation group were shorter than those in the control group, and the amount of intraoperative bleeding was less than that in the control group (P < 0.05); the effective rate of the observation group was 97.62%, which was higher than 76.19% of the control group (P < 0.05); the incidence of complications in the observation group was 4.76%, lower than 19.05% in the control group (P < 0.05). Conclusion The application of tension-free repair in elderly inguinal hernia has a significant effect, which can not only improve the treatment efficiency, but also reduce the incidence of complications.