This study considers repair of inguinal hernia under local anaesthesia with intravenous sedation and analgesia in two distric hospitals of NWFP. Data of the sutdy was collected in surgical units of Agency head Quarters hospital Landikotal and Distric Healdquarter Hospital Bannu, over a period of five years from January 1994 to December 1998. Total number of patients were 180. Seventy five patients (41.4%) were of high risk (ASA-IV). Patients were admitted on the day of operation. The aim of the sutdy was to justify the use of local anaesthesia with intravenous sedation and analgesia for the repair of inguinal hernia in district hospitals. Majority of patients (66.6%) were stress free preoperatively. One hundred and thirty five patients (75.0%) were pain free during operation Anaesthesia effects and associated sedation and analgesia relieved post operative pain for 4 - 5 hours in 83.3%. Majority of the patients (97.2%) had a short recovery time and were discharged on first post operative day. There was no mortality. Complications were recoreded in 81 patients. Short hospital stay makes this procedure cheaper than repair done under general anaesthesia. it is concluded that in district hsopitals where the working conditions are poor, the repair of inguinal hernia with intravenous sedation and analgesia is an advantageous procedure because of; greater safety, better post oeprative pain control, short recovery time and reduced cost.