Background: Inguinal hernia repair is the most common procedure in general and visceral surgery worldwide. Over the past two decades, laparoscopic inguinal hernia repair has become more and more popular. Objective: To enhance outcome of TEP, test feasibility, and count the cost of mesh fixation using staples and non-mesh fixation. Patients and methods: This study was conducted in Theodor Bilharz Research institute [TBRI] and Al-Azhar University Hospitals during the period from December 2017 to April 2019.This study included 40 patients with inguinal hernia underwent TEP repair. Patients were divided in to two equal groups: Group A include patients underwent TEP repair with no mesh fixation, and Group B underwent TEP repair using tack fixation of mesh. Results: Regarding operative time, it was slightly longer in mesh fixation group. No intraoperative complications have been encountered in groups including bleeding, peritoneal tear or visceral injuries. Regarding postoperative period, there was no difference in the postoperative parameters between both groups including pain, hospital stay and recurrence. Conclusion: Totally extra-peritoneal approach (TEP) was an acceptable procedure for inguinal hernia repair with less visceral and vascular injuries. No difference in outcome between mesh fixation and non-mesh fixation in TEP repair of inguinal hernia.