BACKGROUND: Recently, a tension-free herniorrhaphy method using mesh prosthetics has been per formed increasingly in Korea. However, there are few reports discussing the patch-closure method and providing guidance for its use. Therefore, it is necessary to evaluate the clinical significance of using patch-closure method for adult hernia patients. METHODS: From among 239 adult hernia patients a clinical analysis was done retrospectively on 37 patients who had undergone a tension-free herniorrhaphy. The clinicopathologic features analyzed were age, sex, location, symptom, type of operation, anesthetic method, recurrence rate, use of postoperative analgesics, operating time, complications, and length of hospital stay. The clinical features of the tension- free hernioplasty group and a conventional hernioplasty group were compared. RESULTS: The period of analgesics use was significantly shorter in the tension-free hernioplasty group than in the conventional hernioplasty group (p<0.01, 1.5 days vs 2.8 days, respectively). The operative time was significantly longer in the tension-free hernioplasty group than in the conventional hernioplasty group (p<0.01, 105.8 min vs 71.6 min, respectively). The recurrence rate after a conventional hernio plasty was 2.3% (4/117), but there was no recurrence after a tension-free hernioplasty. CONCLUSION: A tension-free hernioplasty with mesh is a pain-relief operation and has tendency for lower recurrence. It is suggested that a tension-free hernioplasty with mesh should be performed for old-aged people and recurrent cases.