Inguinal hernia repair is one of the most common surgical procedures worldwide. The choice of mesh—biological or synthetic—significantly impacts patient outcomes, operative time, and cost-effectiveness. This study aimed to compare demographic, clinical, operative, and postoperative outcomes between the two mesh types in inguinal hernia repair.This retrospective analysis included cases of inguinal hernia repair using biological and synthetic meshes. Demographic variables, comorbidities, operative details, and postoperative outcomes were compared. Statistical significance was assessed for key parameters such as operative time, postoperative complications, and recurrence rates.The study cohort comprised predominantly male patients (96.3%) with a mean age of 50.17 ± 13.8 years. Smoking was prevalent (81.5%), and diabetes mellitus (16.7%) was the most common comorbidity. Biological mesh repairs were associated with significantly longer operative times (91.74 minutes vs. 85 minutes; p = 0.024) and higher rates of complications, including pain (18.5% vs. 3.7%), foreign body sensation (18.5% vs. 3.7%), and seroma formation (22.2% vs. 3.7%; p = 0.043). Wound infections (18.5% vs. 7.4%) and hematoma (18.5% vs. 7.4%) were more frequent in the biological mesh group, though not statistically significant. Recurrence rates were higher with biological mesh (14.8% vs. 7.4%), but differences were also not statistically significant.