Repair of inguinal hernia is a great challenge for the surgeons. Over decades different types of repair have been attempted. Many original repairs have been modified over years. We, the surgeons are always looking for a gold standard repair. In such goal, in our institute, Khulna Medical College Hospital, Bangladesh, we have done over 700 cases of open preperitoneal inguinal hernioplasty. In this book, the results of available 210 cases of preperitoneal repair have been mentioned and analyzed with 200 cases of other types of repair. The overall results were excellent in contrast to the other techniques of repair of inguinal hernia. These are comparable with the outcomes of laparoscopic repairs. Moreover, in many situations, even the outcome is more attractive than the laparoscopic repairs. Preperitoneal inguinal hernioplasty is a superior repair technique in terms of infection rate, recurrence rate and other operative parameters. Therefore, this can be claimed that preperitoneal repair is the most resilient, effective and sustainable repair so far for repair of inguinal hernia. This is a triumph in the very complex arena of inguinal hernia repair for the surgeons and researchers.