Objective To compare the effect of laparoscopic high ligation of the hernial sac and open surgery on testicular development and prognosis of children with indirect inguinal hernia.Methods A total of 300 children with indirect inguinal hernia admitted to the First Maternal and Child Health Hospital of Huizhou from January 2015 to December 2018 were selected as the research subjects.They were divided into the control group (n=150) and the observation group(n=150) according to random number table method.In the observation group, laparoscopic high ligation of the hernia sac was used, and in the control group, open surgery was adopted.The clinical indicators, testicular volume, complications, and recurrence of the two groups were compared.Results In the observation group, hospital stay and operation time were shorter than those of the control group, the hospitalization cost was higher than that of the control group, the intraoperative blood loss was less than that of the control group, and the differences were statistically significant (P＜0.05).There was no statistically significant difference in testicular volume at healthy side after surgery (P＞0.05).After surgery, the volume of the affected testicle of the observation group was larger than that of the control group, and the difference was statistically significant (P＜0.05).The volume of the affected side was not significantly different form that of the healthy one in the observation group (P＞0.05).The scrotal edema, testicular atrophy, affected side varicocele and recurrence rate were compared between the two groups, the differences were not statistically significant (P＞0.05).Conclusion Compared with open surgery, laparoscopic high hernia sac ligation in children with indirect inguinal hernia has fewer traumas, which is conducive to the recovery of the children after surgery, less recurrence after surgery, and will not affect the testicular development of the children.