Objective The present work compared the efficacy of sugammadex and neostigmine on reversing neuromuscular blockade induced by rocuronium in children undergoing laparoscopic inguinal hernia repair. Methods Forty children, American Society of Anesthesiologists (ASA) grade Ⅰ or Ⅱ, scheduled for laparoscopic inguinal hernia repair were divided into sugammadex (S) group and neostigmine (N) group (n=20) according to the random number table method. Patients received intravenous midazolam, fentanyl, propofol， and rocuronium for induction， followed by sevoflurane maintained anesthesia. Neuromuscular blockade was monitored for a train of four stimulation (TOF) measurement using acceleromyography. Sugammadex 2.0 mg/kg or neostigmine 0.05 mg/kg and 0.01 mg/kg atropine were administered intravenously in patients of group S or group N， respectively， at the reappearance of the second response of the TOF. The time of TOF ratio (TOFR) recovery to 0.7, 0.8, 0.9， and the time of extubation and discharging from the post‑anesthesia care unit (PACU) were recorded. Heart rate and blood pressure were recorded before and 2, 5, 10 min and 30 min after the administration of the reversal agents. The incidences of postoperative pain, agitation, nausea, vomiting and shivering were also recorded in PACU. Results The times to achieve TOFR of 0.7, 0.8, 0.9 and extubation were significantly shorter in group S (P<0.05), but no significant difference was found in PCAU length of stay between the two groups (P>0.05). The average heart rate at 2, 5, 10 min after reversal and mean arterial pressure at 2, 5 min after reversal were significantly lower in group N than in group S (P<0.05). There was no significant difference in the incidences of postoperative pain, agitation, nausea, vomiting and shivering between the two groups (P>0.05). Conclusions Sugammadex can achieve significantly faster recovery of neuromuscular function after rocuronium and extubation times than neostigmine in pediatric patients undergoing laparoscopic inguinal hernia repair.