Background: The Lichtenstein Mesh technique is currently considered the gold standard for tension free repair of inguinal hernia repair with worldwide acceptance. The darning technique, though tissue based and less popular is believed to be tension free and is commonly practised in our environment with few reports on its effectiveness. Aim: To evaluate darning and Lichtenstein techniques of inguinal hernia repair in terms of frequency of post complications, recovery and cost effectiveness. Method: Consenting patients with uncomplicated inguinal hernia were randomized to have their hernias repaired either by the Lichtenstein mesh technique (Group A) or the Darning technique (Group B). Details of their socio-demographic and hernia characteristics, intra-operative findings and duration of posterior wall repair were recorded. Post operatively patients were assessed for pain, wound site complications and recurrence. The cost of operation and other related treatments were calculated for patients in both groups. Follow up period was 6 months. Result: Sixty seven patients with uncomplicated inguinal hernia were studied. Thirty three of them had Lichtenstein mesh repair while thirty four had Darning repair. Operation time for darning repair was found to be significantly shorter than mesh repair with a mean difference of 4.3 minutes. Lichtenstein repair was however associated with less pain in the immediate post-operative period (p value<0.004) while more patients in the Darning group had pain at 10 days and 1 month post operatively. Analgesic requirement was less in the Lichtenstein group with a mean difference of 2.8 days and the time of return to work activities was similarly shorter in the Mesh group, both of these were statistically significant ( p-value<0.05). Wound haematoma and scrotal oedema were the commonest complications observed in the two groups. There was no statistical difference in the frequency of wound site complications between the two groups. No recurrence was recorded in both groups. The cost of operation and other related treatments was less in the Darning group. Conclusion: Darning technique compares favourably with Lichtenstein technique in terms of early post-operative complications and it is cheaper than Lichtenstein technique. The advantage of the Lichtenstein technique however is the shorter recovery period and less post –operative pain.