Objective: Ideal technique for effective inguinal hernia repair is still controversial. 
Patients and methods: The presented study was conducted on 80 male patients with uncomplicated unilateral primary 
inguinal hernia. The patients were randomly selected either for modified Shouldice repair (36 patients) or Liechtenstein 
repairs (44 patients). Patients were followed postoperatively for 2 years. 
Results: The mean age of the patients was 34.4 years for Shouldice group and 32.7 for Lichtenstein group. The mean operative time was 74 minutes for modified Shouldice repair and 56 minutes for Lichtenstein repair. No intra-operative complications occurred in patients of both groups. Postoperatively, in the Shouldice group, 18 patients (50%) reported slight pain, 12 (33.3%) reported moderate pain and 6 (17.7%) reported severe pain, while in the Liechtenstein group, 11 patients (25%) reported no pain, 20 patients (45.6%) reported slight pain and 13 (29.4%) reported moderate pain. The patients of Lichtenstein group required postoperative analgesia less than patients of Shouldice group. The mean hospital stay was 4 days for Shouldice group and 2 days for Lichtenstein group. The mean time of return to unrestricted physical activities was 16 days in Shouldice group and 12 days in the Lichtenstein group. Early postoperative complications were, inguinal seroma reported in one patient (2.8%) of the Shouldice group and in 3 patients (6.9%) of the Lichtenstein group and superficial wound infection in 2 patients (5.6%) of Shouldice group and in one patient (2.3%) of Lichtenstein group. During the period of follow-up, pain at the surgical site was reported in 6 patients (16.7%) of Shouldice group and in 12 patients (27.3%) of Lichtenstein group, feeling of a foreign body in the groin was reported in 16 patients (36.4%) of Lichtenstein group. There was no statistically significant difference between pre- and postoperative spermogram and Doppler flow parameters for both groups. 
Conclusion: Both techniques are largely equivalent with advantage for the mesh repair because of easier performance, shorter operative time and rapid return to full physical activities.