Hernia repair remains one of the most frequently performed surgical procedures worldwide. While mesh-based repairs have gained popularity due to their lower recurrence rates, concerns regarding mesh-related complications persist. This study evaluates the clinical outcomes, recurrence rates, and complication profiles of mesh versus non-mesh hernia repair techniques in patients with inguinal and ventral hernias. Objective: This study aims to compare the effectiveness of mesh versus non-mesh techniques in hernia repair, focusing on recurrence rates, surgical site infections, chronic pain, and overall patient recovery. Methods: A prospective cohort study was conducted on 350 patients undergoing elective hernia repair. Patients were divided into two groups: Group A (mesh repair, n=200) and Group B (nonmesh repair, n=150). Primary outcomes included operative time, post-operative pain scores, recurrence rates, and complication rates. Statistical analysis was performed using SPSS v.26, with p<0.05 considered statistically significant. Results: Mesh repair demonstrated a significantly lower recurrence rate (3.5% vs. 12.7%, p=0.001) and faster recovery (return to normal activities in 14.3±3.2 days vs. 21.6±4.1 days, p=0.002) compared to non-mesh repair. However, chronic pain was reported more frequently in the mesh group (7.1% vs. 3.9%, p=0.041). Surgical site infections were comparable between both groups (p=0.117). Conclusion: Mesh-based hernia repair offers superior recurrence prevention and faster recovery but carries a higher risk of chronic pain. Patient selection and surgical expertise remain critical factors in optimizing outcomes.