OBJECTIVES: Brazilian public health system covers inguinal hernia repair and the device used in the procedure (heavy weight mesh-HWM). Clinical data reports a higher inguinal hernia recurrence rate for Polypropylene mesh (PM), when compared to a new medical device (Prolene Hernia System - PHS). The objective of this assessment is to compare health and economic outcomes of inguinal hernia repair, conducted by the Unified Health System (SUS). METHODS: Analytic decision tree was made to evaluate the economic impact of recurrence cases from inguinal hernia repair with PM. The study was based on clinical data published by Awad 2007, showing that PM has higher recurrence rate compared to PHS (2.7% versus 0.6% p=0.04) in 17 months. The recurrence rate was projected to 60 months (PM 9.2%; PHS 2.1%) to evaluate the long-term impacts. Reimbursement value of PM, procedure number and cost were obtained from Brazilian public database (DATASUS/Sigtap). One-way sensitivity analysis was performed to verify the robustness of the results. RESULTS: SUS performed 137,414 inguinal hernia repairs in 2008. Appling the recurrence rate by Awad, 3,710 patients will need a second inguinal hernia repair in 17 months (12,642 patients in 60 months) or 9.2% of the total amount of patients surgically treated in 2008. In case of PHS being used as a baseline treatment, the recurrence number would drop by 78% (824 cases) in 17 months and 77% (2,886 cases) in 60 months. The economic impact of PM recurrence is R$ 2,116.694 in 17 months (R$ 7,212.438 in 60 months). CONCLUSIONS: Findings suggest that the PM intervention has less long term effectiveness when compared to PHS treatment option. PHS usage can save resources and can be considered for more rational, evidence-based decision making by the Brazilian public health system.