Background: successful hernia repair is achieving a cost-effective repair with a low recurrence rate, minimal operative and acute and chronic post-operative pain with a rapid return to normal activities. Objective: The aim of this work is to compare the effectiveness and safety of laparoscopic and open repair of ventral hernia and to discuss important controversial issues for both procedures like. Methods: This study has been conducted at Al Azhar university hospitals in Assiut and cairo from January 2015 to January 2016. This study conducted on 50 unselected patients suffering from ventral hernia. Laparoscopic ventral hernia repair performed on 25 unselected patients and open repair for 25 consecutive unselected patients. The open surgical operations were performed using prosthetic mesh, whereas the laparoscopic repairs were performed using the mesh repair technique in all cases. Results: In this Prospective comparative study, the outcomes for 25 unselected patients who underwent laparoscopic ventral hernia repair were compared with those for 25 consecutive unselected patients who underwent open repair. Conclusions: Laparoscopic surgery is a successful treatment option offering significant advantages to patients compared with open ventral hernia repair. laparoscopic ventral hernia repair was safe and resulted in shorter duration of stay in hospital, less complications, early ambulatory period and less recurrence, early return to work. Hence, it should be considered as the procedure of choice for ventral hernia repair.The laparoscopic approach may be more suitable for straight forward hernias, and open repair reserved for more complex hernias.