Purpose <p>The optimal timing and strategy for resuming physical activity after laparoscopic inguinal hernia repair remain controversial. This study aimed to evaluate the safety and effectiveness of a structured physiotherapist-guided rehabilitation program (PRP) in enhancing functional recovery, quality of life (QoL), and safety after uncomplicated laparoscopic transabdominal preperitoneal (TAPP) hernioplasty.</p> Methods <p>We conducted a retrospective cohort study including 6,039 patients who underwent elective uncomplicated laparoscopic (TAPP) hernioplasty between 2013 and 2023. Of these, 4,650 participated in a structured four-phase (PRP), while outcomes were compared with a historical control group of 1,000 patients operated on with the same standardized (TAPP) technique between 2010 and 2012 before (PRP) implementation. Primary outcomes were time to return to daily activities, work, and sports, and (QoL) assessed by a survey. Secondary outcomes were complications, chronic pain, and recurrence.</p> Results <p>Patients in the (PRP) group resumed daily activities significantly earlier, 75% by postoperative day (PD3) and 100% by (PD7), compared with controls 100% by (PD21). Return to sports was faster in the (PRP) group 68% by (PD10) vs. 22% in controls; p &lt; 0.001. Overall complication rate was 1.24%, with a recurrence rate of 0.40%. QoL scores improved significantly at all follow-up points in the (PRP) group.</p> Conclusion <p>In this large single-center retrospective study, the implementation of a structured postoperative rehabilitation program (PRP) guided by physiotherapists was associated with faster functional recovery and improved patient-reported quality of life following uncomplicated laparoscopic inguinal hernioplasty.</p>