Abstract : Hernia is the protrusion of the viscous or part of the viscous into the wall of the containing cavity by a normal or acquired defect. It is possible to categorise these defects as spontaneous (primary) or acquired or by their position on the abdominal wall. Usually acquired hernias occur after surgical incisions and are therefore referred to as incisional hernias. This is a prospective comparative study done on 50 patients with midline incisional hernia, during the period September 2018 to August 2020 satisfying inclusion criteria, attending Surgery OPD. Parameters compared include Time required for surgery, Surgical Site Infection, Duration of hospital stay, Recurrences, Cost. Anatomical repair techniques take lesser operative time compared to meshplasty. It is associated with early return to physical activity, and shorter hospital stay It has been associated with higher recurrence rate than mesh repair. Meshplasty is the almost the gold standard for the incisional hernia, it has better quality of life post-surgery and no recurrence, however it associated with higher incidence of local wound complications compared to anatomical repair and more cost than anatomical repair. Meshplasty with polypropylene mesh is superior to anatomical repair with regard to the recurrence of the hernia.