Abstract: Objective To detect clinical outcome of laparoscopic hiatal hernia tension-free repair. Methods Clinical data and follow-up results of 74 patients who underwent laparoscopic hiatal hernia repair in our hospital from July 2010 to October 2014 were analyzed retrospectively. Results All operations were accomplished successfully with an average operation time of 85-185（107.3±5.6） min， an average operative blood loss of 30-120 （67.2±7.5） ml and an average hospital stay of 3-9 d. Hiatus hernia special patches were placed to repair and reinforce the esophageal hiatus with none complications caused by patch occurred during postoperative follow-up in all operations. Follow up time of 74 patients were 3 -53 （31.0±2.1） months. The main symptoms of 66 cases （89%） were alleviated postoperatively， 8 patients still had preoperative main symptoms， heartburn and acid reflux were found in 2 cases， chest pain in 4 cases， nausea and vomiting in 1 case and dysphagia in 2 cases. None HH recurrence occurred as a result of 3 months postoperative digestive barium meal examination. Conclusion Laparoscopic hiatal hernia tension-free repair has the advantages of safety， minimally invasion， effectiveness and feasibility， which is worthy of further development and promotion.