Objective To compare the curative efficacy and prognosis between laparoscopic and open surgery in treatment of adults abdominal wall hernia. Methods 129 patients of adult abdominal wall hernia from January 2011 to April 2014 were selected as research objects. Retrospectively analyzed their clinical data and then divided them into control group (n = 62) and observation group (n = 67) according to operation method. The control group was given open surgery of herniorrhaphy, while the observation group was given laparoscopic surgery of herniorrhaphy. Then, operation features, postoperative complications incidence, inflammatory factors levels and recurrence rate were record and compared. Results All patients underwent successful operation with herniorrhaphy. In comparison with the control group, the observation group had statistically less bleeding volume during surgery [(21.60 ± 5.80) vs (61.60 ± 10.30) ml], shorter pain time, evacuation active time and hospitalization time [(30.60 ± 6.30) vs (45.20 ± 7.40) h, (14.70 ± 2.50) vs (20.80 ± 4.60) h, (5.30 ± 0.90) vs (8.70 ± 1.30) d, all P < 0.05], while the operation time between the two groups were statistically same (P > 0.05). The total incidence of postoperative complications in the observation was statistically lower than that in control group (14.9 % vs 33.9 %, P < 0.05). As to inflammatory factors, 24 hours and 48 hours after the surgery, levels of IL-6 and CRP in the observation group was respectively statistically lower in comparison with control group (all P < 0.05). After the two-year follow-up, the recurrence rate in the observation group was statistically the same with that in control group (1.5 % vs 6.5 %, P > 0.05). Conclusion Open and laparoscopic surgery of herniorrhaphy are both effective operation methods for adult patients with abdominal wall hernia. However, laparoscopic surgery of herniorrhaphy has less surgical trauma, and it showed more advantages in reducing incidence of postoperative complications, alleviating inflammatory damage caused by operation.