Background <p>Inguinal hernia is a common condition in children, and day-case surgery has been widely implemented in pediatric specialty hospitals, benefiting patients and their families. However, overnight hospital stays pose various inconveniences to children and parents. In this study, we aimed to optimize the day-case surgery model for inguinal hernia repair, evaluate the effectiveness and safety of day-case surgery in children with inguinal hernias, and compare the effects of different surgical methods on hospitalization duration and medical cost.</p> Methods <p>A retrospective cohort study was conducted to analyze surgical data from 14,197 children with inguinal hernias admitted from January 2019 to December 2023 using statistical methods, including independent sample <i>t</i>-tests, analysis of variance, and multiple linear regression analysis.</p> Results <p>The results showed that the day-case surgery model significantly shortened hospitalization duration and reduced medical cost. The hospitalization duration and medical cost in the laparoscopic percutaneous internal ring suturing group were significantly higher than those in the open traditional high ligation of the hernia sac group (<i>P</i> &lt; 0.05). However, the recurrence rate in the laparoscopic percutaneous internal ring suturing group was 0.035%, which was lower than that (0.107%) observed in the open traditional high ligation of the hernia sac group. Laparoscopic percutaneous internal ring suturing aided the detection of hidden hernia at a rate of 49.61%.</p> Conclusions <p>Day-case surgery offers significant benefits by reducing hospitalization duration and medical cost, whereas laparoscopic percutaneous internal ring suturing is better for detecting hidden hernias and shows excellent performance in reducing recurrence rates. Future research should focus on the promotion and optimization of day-case laparoscopic percutaneous internal ring suturing to enhance the treatment outcomes in pediatric inguinal hernias.</p>