This work presents the treatment of patients with large and giant incisional ventral hernias. The results of surgical treatment do not allow surgeons to stop searching for and eliminating/reducing all risk factors which cause an unfavorable outcome of anterior abdominal wall surgery, both in the near and long-term postoperative period. The article discusses: terminology, classification, pathoanatomic changes in the compromised anterior abdominal wall, features of surgical procedures, complications, and their prevention and risks of hernia recurrence. The anatomical and physiological features of the anterior abdominal wall and muscle frame, morphologically altered in the hernia gate area as a result of previous surgical interventions, as well as the constitutional features of patients, are a problematic point of hernioplasty.