Meshes have become indispensable for the repair of abdominal wall hernias. Meshes may not be the most significant feature affecting the clinical outcome of hernia repair; nevertheless, they still exert an influence and worth discussing. Inguinal nerve identification during open hernia repair is associated with less chronic postoperative pain. The aim of this study is to evaluate the use of synthetic meshes in obstructed inguinal hernia. In elective hernia operation, the use of synthetic meshes in hernia repair is the gold standard, but it is controversial in emergency operations. This prospective study evaluates the advantage of the use of mesh in emergency setting. In obstructed/strangulated hernia, infection is the main concern. Methods: Prospective randomized controlled single-blinded study with 40 patients in each group. One group for Lichtenstein repair with polypropylene mesh and the other group had modified Bassini repair with follow-up period of two years. The used statistical analysis was the tstudent/ Fisher test and chi-square test. Results: The hospital stay was significantly less in Lichtenstein repair and the postoperative neuralgia, wound infection, seroma formation were less in mesh repair. Conclusions: In emergency surgery within emergency resection, perforation, the tension-free repair using polypropylene mesh in adults with obstructed hernia should be preferred to conventional hernia repair. For the long time results, a larger study population is indicated.