Laparoscopic repair of inguinal hernias is an increasingly popular method of herniorrhaphy, providing advantages, including lower wound infection rates, faster recovery times and less postoperative pain compared with open procedures. The perioperative incidence of venous thromboembolism (VTE), which comprises deep vein thrombosis and pulmonary embolism, in laparoscopic inguinal hernia repair is low, but VTE is still one of the most common causes of postoperative mortality. Moreover, the VTE risk assessment and prophylaxis in inguinal hernia patients is not well defined. We present an unusual case of sudden death owing to acute pulmonary embolism after undergoing total extraperitoneal inguinal hernia repair. Medline and PubMed databases were searched using the keywords mentioned below, and the literature on VTE risk assessment and prophylaxis in laparoscopic inguinal hernia repair is reviewed. Laparoscopic inguinal hernia repair, which is regarded as a low risk procedure for VTE, has potential risks for VTE development in the perioperative period. The risks come from both surgical procedures and intrinsic patient characteristics. Clinicians should consider both the strength of individual risk factors and the cumulative weight of all risk factors prior to surgery. A full VTE risk assessment is essential with proper prophylaxis measures especially in quality-of-life procedures.