The Lichtenstein tension-free mesh repair opened a new era in groin hernia repair. Without the risk of serious morbidity, it is now readily performed using local anesthesia in patients previously considered unsuitable for surgery. Fears of serious complications related to mesh implantation have proved to be without foundation. As a local anesthetic day care technique without the need for complex and expensive instrumentation, overall costs can be kept to a minimum without compromising the safety or the long-term success of the procedure. It is a straightforward technique to learn, with high patient acceptability and an exceedingly low recurrence rate. At present it must be considered the gold standard of groin hernia repair.