Background: Laparoscopic repair of umbilical and paraumbilical hernia had largely replaced open mesh repair. The purpose of this study was to compare the effectiveness of laparoscopic versus open mesh repair in umbilical and paraumbilical hernia. Patients and methods: It is a retrospective study of 55 patients admitted in Hai Al Jamea hospital (private hospital in Jeddah, Saudi Arabia) between January 2014 and December 2014. Twenty-five cases underwent laparoscopic hernia repair and 30 cases underwent open mesh repair. Results: Postoperative pain by visual analogue scale (VAS) in 1st  24 hours was 3.5 in laparoscopic repair and 7.5 in open mesh repair. Operating time was longer in laparoscopic (74min) compared to open mesh repair (66min). While hospital stay and return to work were shorter in laparoscopic repair (1.3 and 10 days respectively versus 3 and 17 days in open mesh repair). Conclusion: Laparoscopic hernia repair is a complex but efficient method in experienced hands with less postoperative pain, less hospital stay and early return to work.