Polyglycolic acid and silk sutures were used for repair of 321 direct inguinal hernias in 302 patients in a triple-blind randomized trial. A standardized McVay repair was used. A total of 28 recurrent hernias were diagnosed. The cumulated recurrence rate increased gradually to 6.5% after 2 years and to 10.4% after 5 years. No difference was found between polyglycolic acid and silk sutures. It is concluded that repair of direct inguinal hernias may be performed with the same safety with polyglycolic acid as with silk sutures.