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In inguinal hernia surgery, quality of life (QOL) has emerged as a striking issue. Evidence suggests better QOL of patients operated with laparoscopic procedure as compared with open anterior hernia repairs. However data are scarce with relation to open posterior repair in terms of QOL issues. A prospective randomized single-blind study from November 2014 to October 2015 including all patients who underwent elective primary endoscopic [totally extraperitoneal (TEP)] or open Stoppa inguinal hernia repair was undertaken. Mean operating time, intraoperative and postoperative complications, and QOL using short form-36 and Carolinas equation of QOL were analyzed. Physical functioning, mental health, bodily pain, and general health showed advantages of TEP over Stoppa repair in first month of postoperative period. Postoperative prediction of hernia discomfort after 1 year was found to be significantly more in Stoppa repair. Complications were slightly higher with open repair. To conclude TEP is associated with significant increased operative time, better QOL in early postoperative period, and less predicted discomfort after 1 year of surgery.