Incisional hernia repair is a very common surgical procedure. Although many surgical methods were developed, we cannot consider the results to be satisfactory. The recurrence rate is still high. A significant improvement of the outcome was expected after the mesh hernioplasty became a standard and widely used procedure. Current studies show that not just the usage of mesh itself but also the mesh placement into different anatomically preformed spaces between the layers of the abdominal wall make big outcome differences. We present our results with retromuscular sublay mesh hernia repair according to Rives. This method is used in our department for the treatment of large incisional hernia after medial laparotomy. We have used this procedure in a group of 65 patients. The mean follow-up period was 10 months (1–49 months) and during this period there were no recurrences observed. However, we are aware of the very short follow- up time and we expect recurrences in the future. The complication rate was acceptable – three times secondary wound healing, one temporary cardiopulmonary decompensation after operation in a patient with chronic obstructive pulmonary disease that was not diagnosed before operation. Up to now there was no death, no organ injury, no mesh infection, and no enterocutaneous fistula formation. We conclude that the retromuscular hernia repair according to Rives appears to be an appropriate method for the management of large ventral hernias in the course of linea alba with excellent results and a very low complication rate.