Primary and incisional ventral hernias are common conditions often encountered in surgical practice. Because of the frequency of this problem it has come to be managed by surgeons in general, regardless of the type of hospital or the conditions dealt with in their daily practice. Laparoscopic surgery has demonstrated to have an important role among the different technique described to repair ventral hernia with less recurrent rate, less morbidity and less overall cost than open conventional repair, with all the advange of the laparoscopic approach. As a result the indications for this surgical technique are currently being debated since the advantages are evident and progressive implementation is ensured. Now is the time to analyze the usefulness, results, technical variants, anatomic, physiologic and scientific basis and implications involved in implementation of laparoscopy as the technique of choice.