Purpose: Laparoscopic hernia repair has become a popular minimally invasive surgical option in recent decades, offering reduced postoperative pain, shorter hospital stays, and faster recovery. However, there is ongoing debate regarding its safety and effectiveness in elderly patients. Methodology: This retrospective cohort study included all consecutive patients aged 75 years old who underwent elective laparoscopic (TEP) inguinal hernia repair between 2005 and 2023. Data collected included pre- and post-operative Visual Analogue Score (VAS), Modified Carolina's Comfort Scale (MCCS) and CCS scores, complications, and associated pathology. Results: There were 93 patients (79 males: 84.9%) with a mean age of 79.3 years who underwent 122 TEP inguinal hernia repairs, including 18 (14.8%) recurrence. Twenty-nine (31.2%) were bilateral, 80 (65.6%) were indirect. Associated pathology consisted of 10 femoral hernias, with three (21.4%) occurring in 14 females and seven (8.9%) in 79 males. Additionally, 10 obturator hernias were identified, with five occurring in females (35.7%) and five in males (6.3%). No major complications were observed, with minor complications in seven (7.5%) individuals. The average preoperative VAS pain score was 3.4, which decreased to 1.0 at 2-weeks and 0.11 at 6-weeks postoperatively. The preoperative cumulative average MCCS score was 12/75 (ratio: 0.16 +/- 0.2), and postoperative average CCS scores were 3.57/100 (ratio: 0.04 +/- 0.07) at 2-weeks and 0.64/115 (ratio: 0.01 +/- 0.02) at 6-weeks respectively. Conclusion: TEP inguinal hernia repair in elderly patients offers satisfactory outcome with minimal morbidity and significant improvement in functional and pain scores.