Objective To explore the safe and effective surgical treatment for inguinal hernia in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods The clinical data including treatment and follow-up of 41 patients with 43 sides treated in our hospital from January 2013 to December 2019 were analyzed retrospectively. Results The incidence of inguinal hernia in 792 peritoneal dialysis (PD) patients was 5.2% (41/792). Average age was (62.1±10.7) years old and body mass index (BMI) was (21.6±4.9) kg/m². There were 23 cases with primary diseases chronic glomerulonephritis (56.1%), 10 cases diabetic nephropathy (24.4%) and 4 cases hypertensive renal sclerosis (9.7%). The period of dialysis was (17.3±14.9) months before diagnosis. Thirty-nine cases were unilateral hernia and 2 cases were bilateral hernia. Eleven sides were Chinese classification type Ⅰ hernia, 30 sides type Ⅱ and 2 sides type Ⅲ. The diameter of hernia ring was (2.6±0.9) cm. All patients underwent successful tension-free mesh repair, including 41 sides with Lichtenstein and 2 sides with anterior UHS procedures. The average operative time was (46.7±17.3) min. There was complication rate of 19.5% including 3 cases seroma and 2 cases scrotal edema. Surgical site bleeding, infection and chronic pain were one case each. Automated peritoneal dialysis (APD) was given 39 cases (14-33) d and temporary central venous catheterization hemodialysis 2 cases as postoperative transitional dialysis. No recurrence of hernia occurred during the period of follow-up (29.7±15.7) (2-65) months. Conclusions Open tension-free Lichtenstein procedure with light flat mesh has satisfactory effect and is preferred choice for the treatment of inguinal hernia in CAPD patients. APD could be first choice for transitional dialysis.