In today's financial climate, ambulatory treatments that offer rapid return to full activity, perhaps using local anesthesia, are preferred to more complex procedures as long as they are shown to be effective in managing the disease.This prospective trial is done to evaluate outcome in 112 consented male patients underwent 116 elective open primary inguinal hernia repair on day-case basis. The operation is conducted under local anesthesia given by the surgeon. The inguinal canal floor is reinforced by a tension-free polypropylene mesh. A single dose of prophylactic antibiotic (1 gm of cefoperazone sodium) was given IV before induction of anesthesia for every patient. Patients are discharged home the same day. Follow-up at 1 week, 1 month and 6 months is achieved. No reported mortality. The recurrence rate is nil. No prosthesis required removal or persistent sinus developed during the follow-up period. The overall sepsis rate (all superficial) is 2.58%. There is no urinary, pulmonary, cardiac or CNS complications. Of the 112 patients 21.4% required no pain killers after the first night and about 80% required no further analgesia after the first week. The median time off work is 9 days for office workers and 17 days for manual workers. Inguinal hernioplasty using "onlay sutured tension-free polypropylene mesh under local anesthesia is: simple, safe, substantial cost savings, gives better control of postoperative pain, early return to work, very low rate of recurrence, very low rate of complications and should be emphasized for ambulatory hernia repair.