Obesity can cause an incisional hernia to occur because of increased tension on the abdominal wall from the excessive bulk of thick pannus. In this study, we combined abdominoplasty with onlay/sublay hernioplasty and compared with patients who underwent only hernioplasty for incisional hernia in obese patients. The aim of this study is to evaluate the outcome in view of complications and cosmesis of onlay/sublay hernioplasty with abdominoplasty vs. onlay/sublay hernioplasty in 80 obese patients with incisional hernia. They were divided into four groups. Group A (n=20) with onlay hernioplasty with abdominoplasty and group B (n=20) with sublay repair with abdominoplasty and group C & D (each n=20) with only onlay&sublay hernioplasty respectively. They were evaluated regarding operative time and complications. Sublay hernioplasty with abdominoplasty proved to be better in cosmesis and with fewer complications compared to other procedures in obese patients