PURPOSE: The introduction of a mesh to ventral herniorrhaphy ensures abdominal wall strength without tension, and this procedure has shown a decreased recurrence rate, a shorter hospital stay and less use of analgesics. However, the extensive tissue dissection required for mesh placement leads to increased postoperative complications. Yet with the development of laparoscopic ventral herniorrhaphy, we expect earlier recovery, fewer complications and decreased recurrence rates. This study was done to compare the outcomes after open and laparoscopic ventral herniorrhaphy with using mesh through a retrospective review. METHODS: The outcomes for 20 consecutive patients who underwent laparoscopic ventral herniorrhaphy were compared with those of 20 consecutive patients who underwent open herniorrhaphy. The laparoscopic repairs were performed using the intraperitoneal onlay mesh (IPOM) repair with transfascial fixation method in all the cases. RESULTS: The forty patients (24 women and 16 men) had a mean age of 57.48 years (range, 33~82). The mean follow-up time was 63.4 months. The mean surgery duration (67.4 min vs 142.3 min, respectively, p=0.003) and postoperative stay (4.7 vs 16.2 days, respectively, p<0.0001) were shorter for the laparoscopic group. The number of shots of analgesics during the first 3 days after surgery was 1.9 vs 2.4 shots, respectively (p=0.019). There were fewer complications (30%) and recurrences (5%) among the patients who underwent laparoscopic repair than those for the patients who underwent open repair (65% and 10 %, respectively). CONCLUSION: Those findings shows that laparoscopic ventral herniorrhaphy with transfascial fixation seems to be safe and effective and it showed a shorter operative time, fewer complications, a shorter hospital stay and less recurrence than did open ventral herniorrhaphy.