This study compares the effect of invaginating,  excision of hernia sac without ligation with the traditional method ofhigh ligation of the hernia sac on post-operative pain and recurrence. Patients and methods: This multicenter prospective randomized study included 152 patients with 167 primary indirect inguinal hernias. In group I (54 hernias) the sac was not opened and was inverted with the finger into the peritoneal cavity.   In group E (56 hernias) the sac was excised at the neck without ligation. In group L (57 hernias) the sac was transfixed at the neck and excised in the traditional manner. The repair of the posterior wall of the inguinal canal was done according to Lichtenstein  tension free technique. Mean length of follow up was 81.50± 22.34, 79.35 ±26.76 and 77.83±21.26 months respectively. Results: Postoperative seroma occurred in 1 patient (0.60%) in groupE and 1 patient (0.60%) in group L. Surgical site infection occurred in 2 patients (1.20%) in group I, 1 patient (0.60%) in groupE and 2 patients (1.20%) in group L. Mean postoperative  pain score was 3.04± 2.11, 3.98± 2.33 and 4.06±2.43 respectively (p: 0.049). Chronic pain occurred in 3 patients in group I (1.80%),  3 patients in groupE (1.80%)  and 5 patient in group L (3.00 %) (P: 0.749). The difference between the complications in three groups was statistically insignificant (p: 0.887). Hernia recurrence occurred in 3 patients (1.80%) in group I, 1 patient (0.60%) in groupE and 1 patient (0.60%) in group L (p: 0.429). Conclusion: Invagination  and excision  of the hernia sac do not have adverse effects  on repair integrity.   They limit the dissection and reduce the morbidity and risk of injury to the spermatic cord and surrounded structures. They are safer and more appropriate for repair of sliding hernia. Ligation of the hernia sac in inguinal hernia surgery is not only unnecessary and time consuming but also leads to increased postoperative pain. Recurrence rates are statistically unaffected by not ligating the sac