Ｏｂｊｅｃｔｉｖｅ　To evaluate the effect and safety of ultrasound-guided transversus abdominis plane(TAP) block for elderly patients undergoing inguinal hernia repair.　Methods　Sixty patients scheduled for inguinal hernia repair, ASAⅠ-Ⅲ, over 65 years, were randomly divided into two groups (n=30)： TAP block group (group A) and local anesthesia group (group B). MAP and HR were recorded before anesthesia (T0), before operation (T1), 15 min(T2), 30 min(T3) after the start of the operation and after operation (T4). VAS scores and the number of patients requiring rescue analgesics were recorded at 4, 8, 12, 24 h after operation. Anesthesia complications were recorded. The overall satisfaction of analgesia were recorded from the patients in 48 h.　Results　The VAS scores were lower at 4, 8, 12 h after operation in group A [2(1-2), 2(1-2), 1(0-1)] than that in group B [3(2-3), 3(2-3), 1(0-1)](P<0.05). The number of patients requiring rescue analgesics were lower after operation in group A [0(0%)] than that in group B [20(66.7%)] (P<0.05). The overall satisfaction of analgesia from the patients in group A was higher than that in group B(93% vs 73%)(P<0.05).　Conclusions　Ultrasound-guided TAP block is an effective anesthesia method which has less hemodynamic effects to elderly patients undergoing inguinal hernia repair, it can significantly reduce the consumption of analgesics and improve the overall satisfaction of analgesia from the patients.