Objective: To investigate the effect of ultrasound-guided transversus abdominis plane block (TAPB) on postoperative pain after lower abdominal incisional hernia repair. Methods:Sixty patients, undergoing elective tension-free repair of abdominal incisional hernia, were randomly divided into C group (control group, n=30) and TAPB group (n = 30). The control group received routine general anesthesia, while the TAPB group were given ultrasound-guided transversus abdominis plane block after general anesthesia. The scores of visual analogue scales (VAS) at 2h, 4h, 6h, 24h and 90d after operation, the mean arterial pressure (MAP) and heart rate (HR) before, during and after operation, the intraoperative consumption of fentanyl and remifentanil, the incidence of postoperative nausea and vomiting, and the levels of serum cortisol (Cor), norepinephrine (NE), and interleukin-6 (IL-6) before and 24h after operation were compared between the two groups. Results: Compared with Group C, the VAS scores at postoperative 2 h, 6 h, 24h and 90d, the intraoperative and postoperative MAP, the intraoperative fentanyl consumption, and the levels of Cor, NE and IL-6 at postoperative 24h were significantly lower in TAPB group( P < 0.05). Conclusion: Transversus abdominis plane block can improve patients postoperative analgesia and also reduce inflammation and stress response after abdominal incisional hernia repair.