BACKGROUND The Kugel hernia patch (Davol, Cranston, RI, USA) for treatment of inguinal hernias is a minimal access technique of inguinal herniorrhaphy, which aims to combine the utility of the open operation with the advantages of the laparoscopic procedures. The aim of the present study is to report an initial experience of a cohort of patients with inguinal hernias undergoing repair using this technique. METHODS A prospective series of 107 inguinal hernia repairs performed between January 2000 and October 2003 in 96 patients, using the Bard Kugel hernia patch were entered into the study. Patient comfort, complications, activity levels postoperations and early recurrence were evaluated. RESULTS The median age was 76 years (range 23-88 years). There were 107 inguinal hernias repaired. There were 11 bilateral, 39 left and 46 right sided hernias, 12 were recurrent. There were no major complications. There were no early recurrences. At 6 and 12 months there were one and two hernia recurrences, respectively. A further recurrence was noted at 2 years. There was no consistent relationship between having hernia surgery and loss of mobility. There was no difference in straight leg raising noted following surgery compared to the patients' preoperative score. Ability to shower, dress, reach the toilet or perform housework by day 7 returned to normal. Shopping activities were resumed by day 30 in all patients. CONCLUSIONS The Kugel hernia operation is associated with minimal postoperative pain and rapid return to normal activity. There is a modest hernia recurrence rate, which needs to be addressed.