Inguinal hernia repair is one of the most performed operations worldwide. The development of minimally invasive techniques has significantly altered the surgical management of groin hernias, with Total Extraperitoneal (TEP) repair emerging as a well-established laparoscopic approach. Unlike transabdominal preperitoneal (TAPP) repair, TEP is performed entirely within the extraperitoneal space, avoiding entry into the peritoneal cavity. This approach reduces the risk of intra-abdominal complications like bowel perforation and vascular injuries. Numerous studies have demonstrated that TEP repair achieves recurrence rates comparable to open mesh repair while offering advantages such as reduced postoperative pain, earlier return to normal activities, and lower rates of chronic groin pain. However, the procedure has a steeper learning curve due to the limited working space and complex posterior groin anatomy. This review examines the TEP repair, looking at its indication, mesh fixation methods, and comparison with the TAPP and other open inguinal hernia repairs.