Purpose: This study aimed to determine if the prognoses of inguinal hernia patients improved with the application of lightweight mesh (LWM). Methods: Medline, Embase, and Cochrane library were searched for randomized controlled trails related to laparo-endoscopic inguinal hernia repair with different prosthetic meshes. Data were extracted and analyzed using the guidelines of the Cochrane handbook. The primary endpoints were recurrence and chronic postoperative inguinal pain. The second endpoints encompassed acute postoperative pain, foreign body sensation, seroma, infection, and numbness. Data were processed using Review Manager 5.3. Results: The heavyweight mesh (HWM) had a distinctive advantage for recurrence (RR 2.30; 95% CI 1.21–4.38; P = 0.01), with comparable results for postoperative pain (RR 0.91; 95% CI 0.37–2.22; P = 0.83), foreign body sensation (RR 1.18; 95% CI 0.91–1.51; P = 0.21), seroma(RR 0.87; 95% CI 0.75–1.01; P = 0.06), infection (RR 0.85; 95% CI 0.31–2.34; P = 0.75), and numbness, compared to LWM. Conclusion: HWM had a distinctive advantage over LWM with regard to recurrence. The two types of prosthetic meshes had equivalent outcomes for postoperative pain, seroma, foreign body sensation, infection, and numbness. Studies focused on defect sizes and fixation methods are warranted for further stratification. © 2019, Springer-Verlag France SAS, part of Springer Nature.