OBJECTIVES: The objective of this study was to compare the cost-effectiveness of open mesh versus open non mesh inguinal hernia repair in Mexico from hospital perspective. METHODS: Cost-effectiveness of open mesh vs open non mesh repair was modeled using a Markov model. Model was evaluated as a cohort simulation for a time horizon up to 15 years. Model simulation runs in yearly cycles up to 15 years. Transition probabilities were derived from systematic review and other published sources. Resource utilization data were collected from hospitals in Mexico. Utility values were extracted from published sources. Both costs and outcomes were discounted annually at 5%. Probabilistic sensitivity analysis simulations were repeated 10,000 times and CEAC curves were generated. Results reflect hospital perspective. RESULTS: Over both a five and fifteen year period open mesh repair provides greater benefits in terms QALYs (0.0172 in favor of mesh in 15 years) and fewer recurrences than open non-mesh. When the costs from a payer's perspective were used the open mesh repair was the dominant technology over open non mesh repair. The cost in the open non mesh group was MXP 5161.56 in 5 year perspective and MXP 5975.18 in 15-year perspective. The cost in the open mesh group was MXP 4479.82 in 5 year perspective and MXP 4891.61 in 15 year perspective. Results in the probabilistic sensitivity analysis were similar to deterministic analysis. CONCLUSIONS: Findings suggest that in Mexico, open mesh inguinal hernia repair is very cost effective from hospitals perspective and should be considered standard of care based on superior outcomes and costs.