Objective: Transabdominal preperitoneal laparoscopic surgery (TAPP) inguinal hernia (IH) repair has been an alternative to the Lichtenstein procedure. However, there have been concerns about the risks of TAPP in the elderly. We aimed to compare surgical outcomes between the two surgeries in older men with IH. Methods: We retrospectively recruited elderly men with IH who underwent either Lichtenstein or TAPP surgery from 2020 to 2022 in a tertiary hospital. Inclusion criteria were patients aged 60 years or older with unilateral inguinal hernia. Patients with recurrent, incarcerated, strangulated hernia, and femoral hernia were excluded from the study. Study indicators included characteristics of patients and surgical and postoperative outcomes. The follow-up time was 6 months and one year after surgery. Results: The mean age of patients who underwent Lichtenstein and TAPP surgery was 71 and 67 years, respectively. BMI, prevalence of comorbidities, and Nyhus classification of hernia did not differ between the two groups. Lichtenstein procedure was likely to take longer than TAPP (61.2 mins versus 40.5 mins, p = 0.002). Intraoperative complications were not frequent in both groups. Meanwhile, the pain duration of patients who underwent Lichtenstein surgery was longer than those of TAPP (3.5 days versus 2.1 days, respectively). Additionally, TAPP surgery offered shorter hospital stays than Lichtenstein surgery (3.3±1.6 days versus 5.3±2.1 days, respectively). The most prevalent postoperative complications were seroma, accounting for about 10% in each group. The postoperative complication rate and recurrent rate were similar. Conclusion: Lichtenstein and TAPP surgery are safe and feasible for elderly patients with inguinal hernia. However, TAPP offers shorter operation time, pain duration, and hospital stay than the Lichtenstein procedure.