AIM: Effectiveness of surgery on quality of life in elderly affected by minimally symptomatic inguinal hernia. MATERIAL OF STUDY: Forty male patients aging over 75 years affected by minimally symptomatic inguinal hernia were included. In the first group were allocated 15 patients who refused hernioplasty; in the second were included 25 patients who underwent early elective hernioplasty using an high density polypropylene mesh under local anesthesia. The SF-36 questionnaire was administered to all patients at the time of enrollment and 6 months after. RESULTS: All 8 domains of SF-36 and his related two comprhensive index, Mental Component Summary and Physical Component Summary scores, improved 6 months after surgery in patients of the second group. No significant differences were detected in the first group. DISCUSSION: There is no scientific evidence concerning early repair or watchful waiting strategy for elderly with minimally symptomatic inguinal hernia. in the last years, the evaluation of quality of life have a central role in the decision making of disease. CONCLUSION: Improvement of quality of life in elderly with minimally symptomatic inguinal hernia underwent to early hernia repair hernioplasty could represents a further indication for elective hernia repair.