Background: Incisional hernia is a common health problem and its method of repair [open or laparoscopic] is still under debate. Aim of the work: To evaluate the technique and results of the laparoscopic and the open abdominal incisional hernia repair. Patients and methods: This is a retrospective study conducted on 40 patients with abdominal incisional hernia, admitted to general surgery department of Al-Azhar University Hospital [Damietta]. All records were reviewed for patient demographics, preoperative evaluation, operative and postoperative data. The complications were reviewed and compared between groups. These complications included ileus, cellulitis, flap necrosis, infection, hematoma, seroma, cyst, recurrence and other injuries. Results: The open group had a shorter operative time than the laparoscopic group [85.3±13.21 vs 110.0±10.04 minutes, respectively]. However, time to oral intake [hours] and the duration of hospital stay [days] were significantly shorter in the laparoscopic when compared to the open group [9.20±1.2, 1.92±0.69 vs 20.0±2.4 and 2.70±0.68 respectively]. Postoperative complications showed no significant difference between groups. Conclusion:The laparoscopic repair of incisional hernia is a safe and effective alternative to the open repair with a shorter hospital stay, early oral feeding and a lower rate of complications.