BACKGROUND: Inguinal hernias and hydroceles are the most common surgical inguinoscrotal ailments in children. Herniotomy – the surgical repair of inguinal hernias/hydroceles – is the most common operation performed by paediatric surgeons. Therefore, there is the need for a method with the least post-operative complications and better outcome for patients. OBJECTIVE: To compare early post-operative complication rates of paediatric inguinal hernia repair with incising the external oblique aponeurosis (modified Ferguson) and without incising the external oblique aponeurosis (Mitchell Banks) in University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria. MATERIALS AND METHODS: This is a prospective single blind randomized controlled study carried out between May 2017 and April 2018. A total of 70 patients were randomized into modified Ferguson (n = 35) and Mitchell Banks (n = 35) methods of herniotomy each. The patients were followed-up for 30 days and the pain scores and complications recorded. RESULTS: Most of the patients (91.4 %) were males and their age ranged from 25 to 182 months (median 49.50 months). Majority (71.4 %) were well nourished, One-fifth (20.6%) were underweight. Of the 70 herniotomies performed 74.3% were on the right and 25.7% were on the left. There was no statistical difference in the socio-demographic characteristics of the subjects between the two groups. The haemoglobin genotype and packed cell volume of the patients were also similar between the two groups. Mean durations of procedure was significantly shorter, 22.9±6.3 minutes for the Mitchell Banks compared to 33.5±10.3 minutes for the modified Ferguson (p<0.001). The mean length of incision was also significantly shorter for the Mitchell Banks (2.22 ± 0.41 centimetres) compared to the Fergusons (3.11 ± 0.55 centimetres), (p<0.001). There were no statistically significant differences in the rates of surgical site infections (p > 0.999), scrotal oedema (p>0.999) and hematoma (p > 0.999) between the two groups. CONCLUSION: This study showed that the duration of operation was shorter with the Mitchell Banks method. However the incidences of post-operative complications were similar.