This study aimed to evaluate whether obese patients undergoing inguinal hernia repair surgery have a higher recurrence rate and compare the clinical outcomes of obese and non-obese patients.The databases of PubMed, EMBASE, and Cochrane Library were used to search for eligible studies from inception to November 1, 2024. Mean difference (MD), Odds ratios (OR) and 95% confidence intervals (Cl) were pooled up to analyze. The Newcastle-Ottawa Scale (NOS) scores were used to evaluate the quality of the included studies. This study was performed with Stata (V.16.0) software.A total of nine studies involving 56,833 patients were included in this study. By comparing the baseline information, we found that the obese group had Fewer older (MD=-0.08, I²=62.41%, 95%CI=-0.16 to -0.00, P = 0.04), higher BMI (MD = 2.45, I²=93.67%, 95%CI = 2.08 to 2.81, P < 0.01), more hypertension patients (OR = 1.32, I²=32.96%, 95%CI = 1.02 to 1.67, P = 0.04), more BPH (OR = 0.68, I²=0.00%, 95%CI = 0.49 to 0.94, P = 0.02) and more local anesthesia (OR = 0.82, I²=14.73%, 95%CI = 0.79 to 0.86, P < 0.01) than the none-obese group. In terms of postoperative outcomes, We found that the obese group had higher recurrence rate (OR = 1.27, I²=21.89%, 95%CI = 1.10 to 1.47, P < 0.01), more wound infection (OR = 1.43, I²=0.00%, 95%CI = 1.20 to 1.69, P < 0.01), and more overall complications (OR = 1.12, I²=28.20%, 95%CI = 1.05 to 1.20, P < 0.01).Compared with the non-obese group, the obese group has a higher recurrence rate, more wound infections, and overall more complications.© 2025. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.