Objective To evaluate tension-free repair in the management of recurrent inguinal hernia. Methods From 1/1993 to 12/2002, 163 patients with recurrent inguinal hernia underwent reoperation, clinical data were reviewed. Results The male: female ratio was 138: 25, age from 34 to 76 years. The primary surgery had been traditional hemiorrhaphy without prothesis in 142 cases (87. 1 % , including 65 cases of Bassini ,35 cases of McWay and 42 cases of Shouldice) , a tension-free procedure in 12 cases(7. 4% , including 3 cases of laparoscopic mesh repair) and unknown techniques in 9 cases(5. 5% ). The average interval from the initial surgery to recurrence was 36?14 months (range from 3 months to 10 years). Recurrent hernias were treated with a Shouldice repair in 71 cases(43. 6% ) , a tension-free repair in 92 cases(56. 4% , including a laparoscopic mesh repair in 3 cases). All these 163 cases(100% ) were followed up for 56 ?1 months (range from 30 months to 12 years) after the second surgery. It was found that after reoperation the recurrence rate of Shouldice procedure and tension-free repair was 16. 1% (11/71) and 2. 2% (2/92) respectively (x2 = 8. 327 ,P