Background: An inguinal hernia occurs when tissue protrudes through a weak spot in the abdominal muscles near the groin. Open mesh inguinal hernia repair aims to reinforce the abdominal wall with a mesh implant, reducing the risk of recurrence. This study aimed to assess the outcomes and complications of open mesh inguinal hernia repair. Methods: This cross-sectional study was conducted at the Department of Surgery, Moulvibazar 250 bed District Sadar Hospital from January, 2022 to July, 2023. As the study subjects, a total of 83 cases who had mesh repair for inguinal hernia were enrolled by using a purposive sampling technique. Data were analyzed using MS Office tools. Results: In this study, inguinal hernia recurrence was observed in 3 cases (3.6%), with 2 cases (2.4%) requiring reoperation. Intraoperatively, 96.4% (n=80) experienced no complications, while 1.2% (n=1) each suffered from injury to the spermatic cord and neurovascular structures. Postoperatively, over 10% of participants reported complications, including numbness (18.1%), hematoma (16.9%), scrotal swelling (15.7%), and seroma (13.3%). Conclusions: Recurrence and reoperation rates in open mesh inguinal hernia repair are relatively low. However, physicians should remain vigilant regarding potential postoperative complications such as numbness, hematoma, scrotal swelling, and seroma in patients undergoing this procedure.