Previous studies suggest the use of absorbable synthetic mesh for contaminated and high-risk wounds as a safe alternative to biologic or permanent synthetic mesh in open complex ventral hernia repairs.1 However, there is liIle consensus on the ideal placement of bio-absorbable mesh for a successful abdominal wall reconstruction in open complex ventral hernia repairs. The most common positions are onlay, intraperitoneal, preperitoneal, or retrorectus. Our primary objective was to determine the longterm surgical outcomes of retro-rectus and intraperiteonal placement of mesh.