Objective <p>To evaluate the efficacy and safety of biological mesh in laparoscopic inguinal hernia repair.</p> Methods <p>A retrospective analysis was conducted on 200 patients who underwent laparoscopic transabdominal preperitoneal repair (TAPP) between March 2019 and March 2022. Patients were divided into Group A (<i>n</i> = 100), repaired with acellular matrix biological mesh, and Group B (<i>n</i> = 100), repaired with polypropylene mesh. Follow-ups were performed at 1, 3, 6 months, 1 year, and 3 years postoperatively. Outcome measures included operation time, intraoperative blood loss, postoperative hospital stay, recurrence, infection, seroma, foreign body sensation, and chronic pain.</p> Results <p>No significant differences were observed between the two groups in operation time, intraoperative blood loss, postoperative hospital stay, recurrence, infection, seroma, or chronic pain (<i>P</i> &gt; 0.05). However, the incidence of foreign body sensation was significantly lower in the Group A (<i>P</i> &lt; 0.05).</p> Conclusion <p>The acellular matrix biological mesh is safe and effective in the treatment of inguinal hernia, and can reduce the incidence of postoperative foreign body sensation at the same time, providing a new choice for laparoscopic inguinal hernia repair.</p>