Introduction: After the first report of laparoscopic incisional and ventral hernia repair (LIVHR) in 1993, several studies have proven its efficacy over open method. Among the technical issues,  technique of mesh fixation to the abdominal wall is still an area of debate. This study was done to compare two techniques of mesh fixation: tacker with four corner transfascial sutures versus transfascial sutures alone. Aim: To compare the outcome of ventral hernia repair, using transfascial sutures only versus metallic tacks in addition to 4 corner sutures for mesh fixation in terms of postoperative pain, infection and early recurrence. Patients and methods: We evaluated 20 patients with ventral hernias between September 2014 to July 2016. It was a randomised controlled study that included two groups: Group–I: transfascial suture fixation only and Group–II: tacks and four corner transfascial sutures. Both groups were compared post–operatively in terms of pain, infections and recurrences. Results: Demographic profile and hernia characteristics were comparable. The pain score at 6hours, 24hours, 1week, 1month, 3months and 6months after surgery were lower in group II but was not statistically significant. There were no recurrence in any patients over a median follow up of 16months. Surgical site infection (SSI) was present in 0 and 20% in group I & II respectively. The mean operating time (OT) was 61±23.78 and 35±10.8 minutes in group I & II respectively. Conclusions: This study showed that both techniques of mesh fixation are equally effective in terms of postoperative pain, SSI and recurrences.