Objective To present the initial practice of a novel procedure for the surgical treatment of inguinal hernia -“lateral approach single-incision laparoscopic totally extraperitoneal (L-SILTEP) repair” in certain specific situations. Methods The clinical data of 110 inguinal hernia patients who underwent L-SILTEP in the First Affiliated Hospital of Ningbo University, Shanghai General Hospital affiliated to Shanghai Jiao Tong University School of Medicine, and Shanghai East Hospital affiliated to Tongji University from June 2021 to March 2024 were collected retrospectively. Patients′ demographics, surgical details, length of hospital stay, and postoperative outcomes were analyzed respectively. Results All surgeries were completed successfully and there was no conversion. The median surgical time was 55 (41.25, 70) mins and the intraoperative blood loss was 5 (2，10) mL. In surgery, inferior epigastric artery injury occurred in 5 cases (4.5%) and spermatic cord injury occurred in 1 case (0.9%). The mean visual analog scale (VAS) scores pain assessment at 6, 24, and 48 h after surgery were 3.0 ± 0.8, 1.9 ± 0.7 and 1.1 ± 0.4, respectively. The duration of hospital stay was (3.3 ± 0.7) days. The most common postoperative complication was seroma, which occurred in 9 cases (8.2%). Additionally, extraperitoneal hematoma occurred in 1 case (0.9%) and scrotum effusion in 1 case (0.9%). Conclusions Generally, L-SILTEP is safe, feasible and effective. However，due to its advanced technique-demand, the application of L-SILTEP should be patient-specific and surgeon-specific. The successful implementation of this surgical procedure necessitates extensive training and meticulous attention to the surgical details.