The increasing number of inguinal hernia patients on oral antithrombotic medications creates a challenging balance between bleeding risk during surgery and thromboembolism risk upon discontinuation. This study investigated the safety of the inguinal incision technique for inguinal hernia repair in patients continuing antithrombotic medications at our hospital. Between August 2015 and December 2021, we retrospectively analyzed data from 1,192 patients who underwent inguinal hernia surgery. We compared 225 patients who continued antithrombotic therapy (oral group) and 967 who did not (non-oral group). The oral group was significantly older and had a higher prevalence of ASA III classification. Compared to the non-oral group, the oral group had significantly longer operative times, increased blood loss, extended postoperative hospital stays, and a higher rate of postoperative hematoma. However, no significant difference was observed in the incidence of Clavien-Dindo Class III bleeding, indicating potentially manageable levels of postoperative bleeding. We believe that inguinal hernia repair by inguinal incision technique under continued antithrombotic medications can be performed safely without increasing complications such as postoperative bleeding that requires treatment.