Inguinal hernia repair is one of the most common surgical procedures performed worldwide. Although mesh-based techniques such as the Lichtenstein repair have become the standard treatment due to their low recurrence rates, concerns regarding mesh-related complications, chronic groin pain, infection, foreign body sensation, and cost have stimulated interest in non-mesh alternatives. The Desarda technique, first described by Mohan P. Desarda in 2001, is a tissue-based, tension-free repair that utilizes an undetached strip of the external oblique aponeurosis to reinforce the posterior wall of the inguinal canal. This method seeks to combine the advantages of a tension-free repair with the avoidance of prosthetic materials. Current evidence suggests that the Desarda repair provides recurrence rates, postoperative pain outcomes, and recovery profiles comparable to those of mesh-based repairs in selected patients. This review examines the clinical outcomes, advantages, limitations, and contemporary role of the Desarda repair in inguinal hernia surgery.