Objectives:  This randomized prospective study compares the effectiveness of laparoscopic ventral hernioplasty to the conventional open hernioplasty. Patients  and methods:  Forty patients  with ventral hernias  were randomized into 2 equal groups. Group L treated bylaparoscopichernioplastyand Group 0treatedby openhernioplasty. Patients were followed for 35.5 ±15.3 months in Group L patients and 32.5 ±14.5 months in Group 0 patients. Results:  Mean greater dimension of hernia  defect was 6.40 ±2.76 em in group L and 5.25 ±2.94 ems in Group 0 (p: 0.21). In group L, mean operative time was 59.4 ± 16.4 minutes. In group 0 it was 472 ±13.8 minutes  (p: 0.016). Postoperative pain score 6 hours after surgery was 2.95±1.19 in group L patients versus 3.75 ± 0.786 in group 0 patients (p: 0.017). Group L patients needed a mean of 1.20 ± 0.410 ampoules of 100 mg Pethedine  for analgesia in the first postoperative day versus 2.15 ± 0.671 ampoules in group 0 patients (p < 0.0001).  Mean hospitalization time  was 1.10 ±0.308  days in group  L versus 1.45 ±0.605  days in group  0 (p: 0.027).     had 1 conversion  {2.5%) to the open repair. Postoperative  seroma occurred in 2 patients (5%) in group L and 2 patients (5%) in group 0 Two patients  (5%) in group 0 developed surgical site infection. Hernia recurrence was not seenin either Group. Mean patient satisfaction score for Group L patients was 7 90 ± 1.25 versus 6.00 ± 1.72  for Group 0 patients (p: 0.0003). Conclusion: Compared to open repair, laparoscopic repair is technically  feasible, safe and effective, with good clinical outcome. It is associated with longer time for surgery but reduced post-operative  pain, analgesic requirement,  complication rate and infection rate and earlier return to normal activities.