Inguinal hernia surgery has aroused considerable interest in recent years, with numerous advances being proposed to treat these disorders. Bassini's procedure, based on the importance of the transversalis fascia as a fundamental containment mechanism, was for many years the treatment of choice for inguinal hernia. In our study, covering eight years of activity, we focused our attention on this principle, comparing repair procedures such as Bassini's and those with a preperitoneal mesh, in which the repair involves the transversalis fascia, with procedures based on Lichtenstein's technique in which the fascia is left intact. The investigation protocol was thus based on the performance of the three techniques in parallel by the same surgical team. The parameters of immediate complications, lasting pain and recurrence were used to evaluate the results. The first two occurred infrequently in all groups (a greater incidence was seen with mesh procedures). Recurrence rates after preperitoneal mesh techniques were extremely low, confirming the paramount functional importance of the transversalis fascia. The results of our analysis substantiate the advantage of employing the preperitoneal mesh technique, which opens up new horizons for the treatment of recurrent hernia.