The use of minimally invasive techniques in surgery for inguinal hernias has become an established approach to inguinal hernia repair. A brief history of laparoscopic hernia surgery is presented, including evolution of techniques. Several prospective randomized trials comparing open repairs with laparoscopic procedures are reviewed, and the results of the experience at the authors' institution are presented. Studies on the advantages of laparoscopic hernia repair vary, many showing advantages of the laparoscopic approach over open techniques. With continuing refinement of technique and efforts to minimize the cost differential, there should be a continuing role for minimally invasive hernia repair.