Goals. Improvement of the results of treatment patients with strangulated inguinal hernia by developing and introducing differentiated therapeutic and diagnostic tactics into clinical practice. Materials and methods. In the period from 2011 to 2016, 136 patients with strangulated inguinal hernia were treated at the St. Petersburg Elizabethan Hospital. All patients were divided into 2 groups. I group (the main one, 52 people, including 45 (86.5%) men) was on treatment from 2015 to 2016. Patients of Group I, treated by individual therapeutic and diagnostic tactics with active use of diagnostic and therapeutic laparoscopy. Group II (control group, 84 persons, 71.4% of men) was on treatment from 2011 to 2014. In this group lacked a single diagnostic and treatment concept, which led to late diagnosis, delay in surgical treatment and, as a result, a large number of complications. The age of patients in the study groups varied from 20 to 92 years, the average age was 61.7 ± 19.1 years. Results. Among the patients of group II who underwent resection of the injured organ: 10 (12.0%) had no plastic, 17 (20.2%) had plastic with their own tissues (usually in the manner of Bassini, Postempskiy or Girar- Spasokukotsky), and 3 (3.6%) performed the Liechtenstein operation. In the postoperative period, local complications were noted in 29.8% (25 patients) of cases in group II and 5.7% (3 patients) in group I. General complications were also more common in group II — 25.0% (21), in group I only 1 (1.2%) was diagnosed, which is most likely due to severe somatic pathology of patients, insufficient preoperative preparation and prevention of postoperative complications. The next complications were noted: pneumonia (4.8%), acute cardiovascular insufficiency (2.4%), early commissural intestinal obstruction (2.4%), mesenteric thrombosis (2.4%), peritonitis (1,2 %), gastrointestinal bleeding (1.2%), etc. Adverse outcome was noted only in the control group — from 84 patients 7 died (8.3%). In group I there were no lethal outcomes. Conclusions. The complex diagnostic approach, including the use of ultrasound, the SCT of the anterior abdominal wall and abdominal cavity organs, diagnostic laparoscopy, allows to timely correctly diagnose and adequately assess the viability of the injured organs in 100% of cases. The strangulated habit of the inguinal hernia is not a contraindication to the use of prosthetic methods of hernioplasty, such as laparoscopic, at the time of strangulatedup up to 8 hours and the preserved viability of the impacted organ. If the inguinal hernia is impaction for more than 8 hours and if there are contraindications to laparoscopy, in the absence of necrosis of the injured organ, it is advisable to use hernioplasty by Liechtenstein. In case of necrosis of the injured organ, after resection it is expedient to complete the surgical intervention with Bassini plasty of the posterior wall of the inguinal canal. The proposed differential diagnostic and treatment algorithm for treating patients with impaired inguinal hernia, using diagnostic laparoscopy and laparoscopic hernioplasty, reliably reduces the incidence of general postoperative complications from 25.0% (21) to 1.9% (1) (p <0.05) And local complications from 29.8% (25) to 5.7% (3) (p <0.05), and the mortality rate from 8.3% (7) to 0% (0) (p <0, 05).