This study evaluates the efficacy and safety of laparoscopic ventral hernia repair (LVHR) in a large consecutive series of 850 patients. The authors collected data prospectively or retrospectively on patients who underwent LVHR between November 1993 and October 2002. The mean body mass index was 32, and the mean defect size was 118 cm². Mesh, averaging 344 cm², was used in all cases. The mean operating time was 120 minutes, and the mean hospital stay was 2.3 days. Complications occurred in 13.2% of patients, with ileus and prolonged seroma being the most common. During a mean follow-up of 20.2 months, the hernia recurrence rate was 4.7%, associated with large defects, obesity, previous open repairs, and perioperative complications. The study concluded that LVHR has a low conversion rate to open surgery, a short hospital stay, a moderate complication rate, and a low risk of recurrence. However, larger, long-term, multicenter studies comparing LVHR and open repair are needed to confirm these findings.This study evaluates the efficacy and safety of laparoscopic ventral hernia repair (LVHR) in a large consecutive series of 850 patients. The authors collected data prospectively or retrospectively on patients who underwent LVHR between November 1993 and October 2002. The mean body mass index was 32, and the mean defect size was 118 cm². Mesh, averaging 344 cm², was used in all cases. The mean operating time was 120 minutes, and the mean hospital stay was 2.3 days. Complications occurred in 13.2% of patients, with ileus and prolonged seroma being the most common. During a mean follow-up of 20.2 months, the hernia recurrence rate was 4.7%, associated with large defects, obesity, previous open repairs, and perioperative complications. The study concluded that LVHR has a low conversion rate to open surgery, a short hospital stay, a moderate complication rate, and a low risk of recurrence. However, larger, long-term, multicenter studies comparing LVHR and open repair are needed to confirm these findings.