Background: Open Lichtenstein inguinal hernioplasty is universally accepted as a safe, well-understood method with a high success rate, the laparoscopicrepair of an inguinal hernia is a comparatively recent technique. Although the laparoscopic approach to a hernia repair procedure is related to less pain and faster recovery than openrepair, many surgeons are not familiar with this technique due to the technical demands and a long learning curve. In literature, there is controversy about the efficacy of both techniques. So, this study is conducted to evaluate a technique with better efficacy that will be offered to the patients in the future. Objectives: To compare the outcome of open mesh hernioplasty (Lichtenstein technique) with laparoscopic total extraperioneal (TEP) mesh repairs for the treatment of inguinal hernias. Study Design: Randomized control trial. Setting: Department of Surgery, Allied Hospital, Faisalabad. Period: From 7th February 2014 to 6th August 2014. Materials and Methods: 154 male patients with age between 20-45 years were included. Patients having INR > 1.5, history of chronic cough and previous abdominal surgery were excluded. Laparoscopic hernioplasty was performed in group A (n=77) and open hernioplasty was performed in group B (n=77). Results: The mean age of the patients was 32.91±7.78. In group A, 3 (3.9%) patients had ascrotal hematoma, while it was 12(15.6%) in group B. There is statistically significant difference between two groups (p-value=0.014). Conclusion: Laparoscopic TEP can be performed safely with acceptable postoperative complication and is better treatment modality than open mesh hernioplasty.