Background: In laparoscopic ventral hernia repair (LVHR) there are many modifications related to the methods of mesh fixation. Using trans-fascial sutures decrease the chance of mesh shrinkage and migration and subsequent hernia recurrence but it is still controversial in comparison with tackers alone. Objective: The study goal was to assess the effect of adding four corners trans-fascial sutures to double crown tackers for mesh fixation. Patients and Methods: A total of 50 patients with different types of abdominal wall hernias were subjected to LVHR. Patients were randomized into two groups: Group A where mesh was fixed using double crown of tackers only and group B where mesh was fixed using both tackers and four corners trans-fascial sutures. Mesh fixation duration, postoperative pain score and recurrence rate were recorded. Results: Males and females were 21 and 29, respectively. The mean age was 48 years. Types of hernias were 29 para umbilical hernias (PUH), 17 incisional hernias and 4 epigastric hernias. In Group A, the median operative time for mesh fixation was 15 mins. In group B, the duration was 24 minutes. The median Visual Analogue Scale (VAS) for pain was 1 at 24 hours post-operative. The average hospital stay post-surgery was between 1 to 3 days. Within 12 months, three patients from group A experienced a recurrence of their hernia. Conclusions: LVHR with tackers was an easy and time saving procedure. However, adding trans-fascial sutures decreased the chance of mesh shrinkage/migration and gave less recurrence rate.