Laparoscopic inguinal hernia repair in children was started over two decades ago and it has been gaining popularity day by day. There were several emerging laparoscopic techniques with trends toward extracorporeal suturing and knotting technique, single-port access technique as well. In this study A prospective randomized controlled study was carried out in the Pediatric Surgery department of Sylhet M A G Osmani Medical College Hospital and 2 other private hospitals in Sylhet, Bangladesh from July 2015 to June 2017. One hundred and twenty-four patients with Inguinal Hernia (IH) were randomized into two equal groups by a random-number table sequence after taking a written informed parental consent. Group A (n = 62) was subjected to needle assisted laparoscopic inguinal hernia repair by Spinal Needle (20 G) and Group B (n = 62) was subjected to open herniotomy (OH). Results were satisfactory in Group-A. So laparoscopic inguinal hernia repair by Needle assisted extracorporeal knotting technique can be an alternative of open herniotomy in children.