Abstract: Objective To evaluate the effects of local anesthesia and epidural anesthesia in tension free inguinal hernia repair. Methods Electronic databases including PubMed, EMBASE, MEDLINE, Chinese Academic Journal Full-text Database were searched to identify randomized controlled trials （RCTs） that reported the effects of local anesthesia and epidural anesthesia in tension free inguinal hernia repair. Evaluation indicators were included: operation time, length of hospital stay, cost, rate of wound pain and recurrence. Results There are 19 RCTs, 4 516 patients included in the meta analysis, 2 330 cases in local anesthesia group and 2 186 cases in epidural anesthesia group. Meta analysis indicated that operation time WMD=-5.36 min, 95%CI （-5.67, -5.06） min, P< 0.000 01, length of hospital stay WMD= -2.82 d, 95%CI （-2.89, -2.75）d, P< 0.000 01, cost WMD=-998.83 yuan, 95%CI （-1 004.96, -992.71） yuan, P< 0.000 01, and rate of wound pain OR=0.67, 95%CI （0.49, 0.91）, P=0.01 in local anesthesia group were better than those in epidural group. But recurrence was not significant differencesRR=1.28, 95%CI （0.54, 3.01）, P=0.58. Conclusion Compare to epidural anesthesia, tension free inguinal hernia repair with local anesthesia has the merit of shorter operation time, shorter length of hospital stay, lower cost,less wound pain and the same recurrence.