
Introduction: While mesh hernioplasty is increasingly getting popular, anatomical repair of ventral hernia is still commonly done by surgeons. In this study we have compared the effectiveness of mesh hernioplasty versus anatomical repair in the treatment of primary midline ventral hernias. Material and Methods: 30 patients of primary midline ventral hernia were treated by mesh hernioplasty while 30 patients were treated by anatomical repair. Results were compared in terms of duration of surgery, local complications and recurrence. Result: Average duration of surgery is longer for mesh hernioplasty compared to anatomical repair. Local complications (hematoma, seroma and surgical site infection) are more common in mesh hernioplasty cases compared to anatomical repair. In our study no recurrence was seen after mesh hernioplasty but 2 (6.6%) cases of anatomical repair recurred during 6 months follow-up period. Discussion and Conclusion: While mesh hernioplasty takes longer duration to perform and has high local complication rate; it has lower recurrence rate compared to anatomical repair.