Background <p>Sexual function following primary inguinal herniorrhaphy is a frequently discussed issue. Mesh repair methods, including Lichtenstein, Totally Extraperitoneal (TEP), and Transabdominal Preperitoneal (TAPP) repairs, are generally preferred. This review aims to address the ongoing debate regarding whether there is a difference in postoperative sexual function between Lichtenstein repair and laparoscopic repair techniques.</p> Methods <p>A literature search of PubMed and Web of Science databases was conducted to obtain studies on sexual functions comparing Lichtenstein and laparoscopic repair in primary inguinal hernias.</p> Results <p>In this study, we included seven randomized controlled trials (RCTs) and one cohort study involving 2,538 patients with primary inguinal hernia who underwent Lichtenstein, TAPP, or TEP repair. We found that the overall incidence of pain during sexual activity was significantly higher in the Lichtenstein repair group compared to the laparoscopic repair group (OR = 1.91; 95% CI: 1.13, 3.25; <i>P</i> = 0.020). However, no significant differences were observed between the groups in terms of erectile function (<i>P</i> = 0.580), testicular pain (<i>P</i> = 0.620), and scrotal swelling (<i>P</i> = 0.820). Notably, pain was higher in the TEP group as opposed to Lichtenstein group, however this was not statistically significant (OR = 0.51; 95% CI: 0.23, 1.12; <i>P</i> = 0.090).</p> Conclusions <p>Lichtenstein repair did not significantly impact postoperative sexual function compared to laparoscopic repair, except for a higher incidence of pain during sexual activity.</p> Graphical Abstract <p></p>