Objective To explore the application of Halsted operation in emergency repair of incarcerated inguinal hernia. Methods The clinical data of 49 male patients with incarcerated inguinal hernia admitted from January 2016 to December 2018 in our department were analyzed retrospectively. All the patients underwent emergency operation using Halsted hernia repair. There were 36 cases with small intestine necrosis and 6 cases with impaction necrosis of greater omentum found during operation. Drainage tube was retained in abdominal cavity for the patients with intestine necrosis and negative pressure drainage tube was inserted in first interspace. Postoperative follow-up was conducted by telephone or out-patient clinic. Results The operation was successfully completed in all 49 patients. Three cases died of respiratory failure caused by pulmonary infection, and the other 46 cases were cured. Perioperative complication was found 5 cases with incidence of 10.2% 7 days after operation. Patients were followed up for an average of (37.0±8.6)(24-60) months with 2 cases recurred and 4 cases lost follow-up. There was without any local infection of incision. Conclusions In the emergency inguinal hernia repair, Halsted repair has the advantages of simple procedure, low postoperative pain rate and has some clinical value when surgical site infection is controlled.