Inguinal hernia is a common general surgical disease, and surgical repair is the only way to cure inguinal hernia. Laparoscopic inguinal hernia repair is the main surgical method. With the development of minimally invasive concept and minimally invasive technology, single-incision laparoscopic inguinal hernia repair has also been developed and applied in continuous exploration and practice. This article describes the application and advantages of single-incision laparoscopic totally extra-peritoneal hernia repair (SIL-TEP) in patients with special anatomical conditions through three case reports. Case 1 was left indirect inguinal hernia combined with umbilical hernia with decompensated liver cirrhosis and abdominal wall varices. Case 2 was right direct inguinal hernia with a history of lower abdominal median incision laparotomy. Case 3 was left direct inguinal hernia with a history of left lower abdominal multiple endoscopic foramen operations. The special anatomical conditions of the three cases increased the difficulty of the conventional three-incision laparoscopic inguinal hernia repair, such as the establishment of channels and space separation. We can optimize the special extra-peritoneal route and space of laparoscopic inguinal hernia repair through SIL-TEP, and complete inguinal hernia repair safely and effectively in patients with special anatomical conditions.