Objective To evaluate the safety and efficacy of day surgery laparoscopic transabdominal preperitoneal repair (TAPP) in high-altitude areas. Methods The clinical data of TAPP patients admitted to the Department of Hernia Surgery, Qinghai Red Cross Hospital between January 2022 and December 2024 were retrospectively analyzed. The patients were divided into the day surgery group and the inpatient group according to the surgical method. Logistic regression was used to calculate propensity score, incorporating variables such as sex, age, ethnicity, body mass index, hernia side, hernia type, and hernia classification. Matching samples were obtained by nearest neighbor 1∶1 without replacement matching, and hospital stay, total hospitalization costs, and postoperative complications were compared. Results A total of 388 patients were included. Among them, there were 342 males and 46 females; the average age was (48.48±16.08) years. A total of 98 matching samples were obtained. In the matched 98 pairs of samples, compared with the conventional group, the day surgery group had a shorter length of stay [1.0 (1.0, 1.0) d vs. 5.0 (4.0, 7.0) d, P<0.001] and a lower total cost [9 335.6 (8 332.9, 10 709.8) vs. 1 1130.7 (959.9, 12 286.9) yuan, P＜0.001]. There was no statistically significant difference in the incidence of early postoperative pain score, postoperative delayed wound healing / infection, postoperative chronic pain, postoperative seroma, and unplanned return visits between the two groups (P>0.05). Conclusions Day-surgery TAPP repair for inguinal hernia appears safe and effective in a high-altitude region, with the added benefits of reduced hospital stay and lower costs. This approach may be considered for wider clinical implementation.