The objective of this study was to evaluate outcome of total extraperitoneal laparoscopic inguinal hernia repair with Lichtenstein open repair in terms of postoperative pain. Quasi experimental study. Surgical unit 1 Rawalpindi and Allied hospitals from January to June 2012. Sixty patients, with unilateral, primary, inguinal hernia were alternately allocated to undergo either total extraperitoneal [TEP] laparoscopic repair of inguinal hernia or Lichtenstein tension free, mesh repair of inguinal hernia. Pain scores at 12, 24, and 48 hours and at 7 days of follow up were noted using a visual analogue scale. Total number of intravenous injections of Diclofenac Sodium requested by the patient for pain relief was also noted. At 12 hours after surgery, the mean pain scores in the TEP group were 3.1 +/- 1.8 and in the Lichtenstein group they were 4.2 +/- 2.1 [p 0.031] . At 24 hours after surgery, the scores were 2.3 +/- 1.5 and 3.1 +/- 1.9 for the TEP and Lichtenstein groups, respectively [p = 0.026] . At 48 hours after surgery, the mean pain scores in the TEP group were 1.5 +/- 1.1 while in the Lichtenstein group they were 2.0 +/- 1.6 [p = 0.041] . At 7 days after surgery, the scores were 0.3 +/- 0.5 in the TEP group and 0.4 +/- 0.8 in the Lichtenstein group [0.137] . The mean number of injection of Diclofenac Sodium required by the TEP and Lichtenstein groups was 3.1 +/- 1.6 and 5.8 +/- 2.2, respectively [p = 0.011] . Less postoperative pain and requirement for analgesics were reported by patients who underwent total extraperitoneal laparoscopic repair of inguinal hernia as compared to those who underwent inguinal hernia repair by Lichtenstein tension free mesh hernioplasty