For Inline::C to work you'll need a make program (either nmake or dmake will do) and you'll need a compiler (either Visual Studio or MinGW).

Strawberry/Vanilla Perl (which includes MinGW and dmake) will provide you with all you need to build and use Inline::C, but it's also not difficult to get it working with ActivePerl, if you want to go that way.

Cheers,
Rob