Background: The optimal technique to cure strangulated umbilical hernia remains controversial. The use of mesh in cases of strangulated hernia is still debated due to the potential risk of infection. This study aimed put a strategy for repairing of strangulated umbilical hernia with or without mesh. Patients and Methods: This prospective comparative study was conducted on patients with strangulated hernia admitted to general surgery hospital Zagazig University during period from June 2018 to January 2019. This study included 30 patients with strangulated hernia, they were divided randomly into 2 groups, 15 patients underwent repair with mesh and 15 underwent repair without mesh. All patients were subjected to Demographic data taking, complete clinical examination. Laboratory investigations and Radiological investigations. Results: Operative times and hospital stay were longer in Group A who underwent repair with mesh, the duration was 60-90 minutes versus 20% only in of group B repair without mesh. That mean of hospital stay among Group A is 4.8 ± 1.65 days, While in Group B mean of hospital stay is slightly shorter 4.2 ± 1.65 with no statistical difference. post-operative complications showed higher in Group A where pus formation and seroma formation were more statistically. Conclusion: The repair of strangulated umbilical hernia with or without mesh are variable, However, these procedures are associated with poor prognoses and a higher rate of post-operative complications.