Background:     Although  open  repair,  preferably with  mesh  has  long  been  the  standard approach for ventral and incisional herniasrepair, laparoscopic repairis becomingincreasingly popular among  surgeons   and  patients  following  the  development  of  minimally invasive techniques. Laparoscopic ventral  hemia  repair  may  be associated with  fewer complications decreased length of hospital stay and lower recurrence rates. The  aim of this comparative study is to evaluate the outcome  and  benefits of laparoscopic over conventional ventral and incision hernia repair. Methods: The  study  was conducted in  Surgery Department Faculty of Medicine Fayoum University, on  forty patients with incisional and primary ventral hernias with defect  size more than  Jcm,  from September 2009  to  December 2011.  Patients were randomly selected    and allocated into two groups using coin and flip method, Group A included twenty patients operated on by laparoscopy and Group B included twenty patients who underwent open surgical repair. Results: Both groups had nearly similar demographics and clinical data. The procedure  was successfully completed in all patients of both groups, with no mortality or conversion to open procedure in group  A The mean  diameter of hernia defect  was 5.6 em in group  A, compared to 6.1 em in group B. Polypropylene mesh  was used  for all patients in group  Band in group  A different types of composite mesh  was used. There was a significant decrease in the need for postoperative analgesia in group A compared to group B (P value <0.05). The study showed less complications and shorter hospital stay in group A, with no recurrence in both groups during a period of follow up for two years. Conclusion:  Laparoscopic ventral   and  incisional hernia   repair is  safe,  effective and technically feasible approach with statistically significant reduction in postoperative morbidity, earlier recovery and shorter hospital stay and with similar  recurrence rate to the conventional open group.