Objective: To investigate the clinical effect of laparoscopic minimally invasive surgery in treatment of incarcerated inguinal hernia in elderly patients. Methods: The clinical data of 132 elderly patients with incarcerated inguinal hernia treated in March 2014 to March 2016 were retrospectively analyzed. Of the patients, 66 cases underwent laparoscopic minimally invasive surgery (laparoscopic group), and the other 66 cases underwent traditional open tension-free hernia repair (traditional group). The main clinical variables between the two groups of patients were compared. Results: The preoperative general data and laboratory parameters showed no significant difference between the two groups (all P>0.05). In laparoscopic group compared with traditional group, the hospitalization cost was significantly increased (P<0.05) and the operative time showed no significant difference (P>0.05), but the variables that included intraoperative blood loss, number of pain sufferers, time to ambulation and length of hospital stay were all significantly superior (all P<0.05). The white blood cell count and levels of inflammatory mediators in both groups of patients were significantly increased at 24-h after operation compared with their preoperative values (all P<0.05), but the increasing amplitudes were significantly evident in laparoscopic group (caused by foreign objects such as patch and mesh-plug). The overall incidence of complications and recurrence rate in laparoscopic group were significantly lower than those in traditional group (4.55% vs. 15.15%; 4.55% vs. 18.18%, both P<0.05). Conclusion: Laparoscopic minimally invasive surgery is safe and effective in treatment of incarcerated inguinal hernia in elderly patients, with the advantages of minimally invasive, reduced complications and fast postoperative recovery.