BACKGROUND: Our intention in this study was to evaluate the effectiveness of a new open mesh hernia repair procedure, the “All in One Mesh Hernioplasty”, for the treatment of primary inguinal hernias in adults. METHODS: Between February 2014 and February 2016, we performed the All In One Mesh Hernioplasty procedure on 400 patient suffering from primary unilateral inguinal hernia at our Institution. The prosthesis was placed on the floor of the inguinal canal, as described in the original technique, and later covered by the fibrocremasteric sheath. Followup visits with the evaluation of postoperative pain using Numerical Rating Scale, and of short and long-term complications were performed after 1, 6, and 24 months. RESULTS: All patients were discharged within three hours after surgery. The majority of patients reported only slight pain at discharge and 31,7% of them were completely painless . One week after surgery 83% of patients reported no pain and no other symptoms. 91 % of patients returned to their normal daily activities within 2-3 days after surgery. We didn’t record any case of postoperative neuralgia or recurrence after a 24 months follow up.