To investigate the clinical safety and effectiveness of acellular extracellular matrix (AEM) for inguinal hernia repair, 53 well-conducted and well-chosen sequential cases with inguinal hernia (56 inguinal hernias) were included in our multi-center study. All the inguinal hernias were repaired using conventional tension-free surgical procedures after being classified with Gilbert methods. No rejection was observed after operation. All the incisions healed well and no recurrence was found at the sixth month follow-up. At the seventh month after operation, one case of recurrence of right-side bilateral inguinal hernia (type IV) and another case of recurrence of left-side inguinal hernia (type V) were found. No other recurrence was observed at the 18th month follow-up. The AEM material has good histocompatibility and biomechanics characters and can be used for inguinal hernia repair. We observed no infection, chronic pain, funiculotesticular reaction, local nodular or feeling of discomfort after operation. But a further study of the usage of AEM in the repair of type IV and V inguinal hernias is still needed.