Objective To investigate the relation between preoperative peripheral blood neutrophil/albumin (NEU/ALB) and hypersensitive C-reactive protein (hs-CRP)/ALB ratios and seroma after laparoscopic transabdominal preperitoneal (LTAPP) hernia repair. Methods The patients diagnosed with inguinal hernia and underwent LTAPP hernia repair surgery admitted to the Heji Hospital Affiliated to Changzhi Medical College from June 2020 to June 2023 were retrospective collected. Multivariate logistic regression analysis was conducted to identify the risk factors affecting the occurrence of seroma after LTAPP repair surgery. The area under receiver operating characteristic curve (AUC) and 95% confidence interval (95% CI) were used to evaluate the discriminatory value of preoperative peripheral blood NEU/ALB ratio and hs-CRP/ALB ratio for seroma after LTAPP repair surgery. Delong test was used to compare the discriminatory value of these indicators. Test level α=0.05. Results A total of 357 patients who met the inclusion criteria were included in this study, and the seroma occurred in 42 cases (11.8%). The results of multiple logistic regression analysis showed that the larger the diameter of the hernia sac [OR (95%CI)=3.021 (1.498, 6.094), P=0.002], the more intraoperative bleeding [OR (95%CI)=4.654 (2.829, 7.657), P<0.001], and the higher the NEU/ALB ratio [OR (95%CI)=2.585 (1.618, 4.130), P<0.001] and hs-CRP/ALB ratio [OR (95%CI)=1.874 (1.239, 2.834), P=0.003], the higher the probability of seroma after LTAPP hernia repair. The AUC (95%CI) of NEU/ALB and hs-CRP/ALB indicators for predicting seroma after LTAPP repair surgery were 0.750 (0.702, 0.794) and 0.762 (0.715, 0.806), respectively. The optimal cutoff values were 2.970 and 4.001, with sensitivity of 78.6% and 73.8%, and specificity of 60.3% and 65.7%, respectively. The AUC (95%CI) of the combined prediction of seroma after LTAPP repair surgery was 0.851 (0.810, 0.886), with sensitivity and specificity of 71.4% and 87.0%, respectively. The AUC of the combined prediction of seroma after LTAPP repair surgery was higher than that of ALB (Z=2.864, P=0.004) and hs-CRP/ALB alone (Z=2.956, P=0.003). Conclusion From the data analysis results of this study, the incidence rate of seroma after LTAPP hernia repair is not low, and the occurrence of seroma should be paid close attention to patients with large hernia sac diameter, more intraoperative bleeding, and NEU/ALB and hs-CRP/ALB ratios.