Background: hydrocele is the most common cause of painless scrotal swelling. The incidence in adult males is approximately 1%, although prevalence varies according to country. Objective: to compare between the two groups? as regards the volume of the hydrocele sac, operative time, postoperative morbidity, length of hospital stay, and time of return to daily life. Patients and Methods: this prospective study was conducted on 40 patients with a diagnosis of unilateral (idiopathic) primary vaginal hydrocele during the period from October 2010 to October 2011. All patients were admitted to the Department of General Surgery, El-Hussein University Hospital, and underwent hydrocelectomy. Results: the age of the patients in the inguinal approach group ranged from 17 to 52 years (mean 30.75±10.67), whereas the patients included in the scrotal approach group had an age range of 16–48 years (mean 29.35±8.93). The difference in mean age between the two groups was statistically insignificant. The mean volume of the hydrocele sac was 196± 30.28 ml (range, 155–250 ml) in the inguinal approach group and 197.75±26.72 ml (range, 150–260 ml) in the scrotal approach group. The difference in mean volume of hydrocele between the two groups was statistically not significant. Conclusion: hydrocelectomy using the inguinal approach in adults is associated with low or no postoperative morbidity, no discomfort, short hospital stay, and early return to normal life. It is easily applied and allows management of any associated lesions in the inguinal canal.