Abstract: Objective To evaluate the efficacy and safety of tension-free repair versus traditional herniorrhaphy in strangulated inguinal hernia. Method We searched the related studies included randomized controlled trials and between-study heterogeneity. PubMed, EMBASE, Cochrane Library, CBM and Wanfang were searched and related journals were hand-searched. Evaluated the quality of the studies. Meta analysis was performed by Revman 5.0 software. Result Eleven studies involving 716 patients were included. In comparison with the traditional herniorrhaphy, fewer time of surgeryWMD=-15.16,95%CI （-22.11,-8.20）, P<0.05; fewer day of postoperative hospital stay WMD=-1.59,95%CI（-2.83,-0.34）,P<0.05; postoperative edema of scrotum, groin bruises and urinary retention did not differ significantly between the two groupsOR=0.77, 95%CI （0.39, 1.51）, P>0.05; OR=3.80, 95%CI （0.91,15.91）, P>0.05; OR=0.62, 95%CI （0.32, 1.22）, P>0.05. Postoperative recurrence rate did not differ significantly between the two groups OR=0.14,95%CI （0.06,0.33）,P<0.05. Conclusion The use of tension-free repair in emergency treatment of strangulated inguinal hernia is safe.