Abstract Background Mechanical fixation in transabdominal preperitoneal inguinal hernia mesh repair (TAPP) is associated with pain syndrome and mesh migration may occur without flat protheses fixation. An anatomical shaped mesh (4DTM Cousin Biotech) using no fixation would improve the pain syndrome. Method A retrospective case study, that included 100 patients and 200 TAPP performed from 2019 to 2023. This study was conducted to compare laparoscopic inguinal hernia repair with (group A) or without mesh fixation (group B) regarding outcomes using two different mesh technologies: well-established flat macroporous partially absorbable mesh and the anatomical shaped partially absorbable lightweight mesh (4DTM Cousin Biotech). Results Recurrence rates, postoperative outcomes, and complication rate and type were analyzed to provide insights into the performance of each mesh in TAPP. There was statistically significant difference in postoperative early pain, assessed via VAS score, 3 days after surgery (group A versus group B; 3,4 ± 1.46 vs. 4 ± 1.6, P <0.001) and a week after surgery (group A versus group B; 1.5 ± 0.9 vs. 2.5 ± 0.6, P <0.001). Operative time, on average, was longer in group B (92 ± 12. vs. 79 ± 20 min, P <0.001). Conclusion The study results revealed that laparoscopic TAPP inguinal hernia repair with anatomical shaped mesh without fixation is safe and feasible with no increase in recurrence rate. In addition, it offers an improvement of operation time than TAPP mesh fixation. However, further study with a longer follow-up will be needed to confirm the results.