Background: The safety and efficacy of Totally Extraperitoneal (TEP) laparoscopic approach for the repair of inguinal hernias in patients with a history of lower abdominal surgery are subject to debate. Concerns arise due to the risk of adhesions, bowel and/or bladder involvement, and obliteration of the extraperitoneal plane, which could complicate surgery. An open approach is often favoured. Methods: We conducted a retrospective analysis of patients who underwent TEP repair of inguinal hernias at our rural centre between 2018 and 2023 by a single surgeon. All patients had previous lower abdominal surgery. Outcomes measured included conversion to open or transabdominal pre-peritoneal repair (TAPP), serious adverse events, prolonged post-operative pain, hernia recurrences and hospital length of stay. Results: 38 patients were identified. 1 (2.6%) patient experienced bladder injury requiring prolonged catheterisation. No cases required conversion to open repair but 3 (7.9%) cases were converted to TAPP. 5 (13.2%) experienced prolonged post-operative pain after 6 months and 1 (2.6%) patient experienced early hernia recurrence. The mean operative time was 75.2 minutes and hospital length of stay was 1.32 days. Conclusion: Our rural centre's experience suggests TEP repair of inguinal hernias in patients with prior lower abdominal surgery is a feasible, safe, and effective approach. This data adds to the evolving body of evidence supporting a minimally invasive approach for inguinal hernia repair regardless of previous surgery.