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Pediatric inguinal hernia is one of the most common surgical conditions with open herniotomy being the gold standard of treatment. With the advances of laparoscopic surgery, it has emerged as an alternative to open repair with reported good results. However, laparoscopic hernia repair is not yet a routine procedure in many centers, and debate of laparoscopic versus open repair still exists. After 20 years of development of laparoscopic hernia repair, different techniques have been described with no consensus on the standard technique right now. This article reviews the latest updates of laparoscopic repair from the current evidence in the literature. Laparoscopic management of hernia in premature/small infants and hernia incarceration are also discussed here.