ObjectiveTo explore the risk factors of recurrence of incisional hernia following incisional hernia tension-free repair. MethodsThe clinical data of 162 patients with incisional hernia underwent tension-free repair were retrospectively analyzed in this hospital from January 2005 to January 2011. The relationships of incisional hernia recur-rence to gender, age, body mass index, hernia size, abdominal wall defect site, preoperative chronic comorbidities, type of tension-free repair, operation time, and wound healing disorders were analyzed by univariate and multivariate analysis. ResultsOne hundred and sixty-two patients were followed up 7-70 months with mean 34.5 months. The rate of recur-rence following incisional hernia tension-free repair was 9.26% (15/162). The results of univariate analysis showed that recurrence following incisional hernia tension-free repair was associated with the age (P < 0.05), body mass index (P < 0.05), type of tension-free repair (P < 0.05), hernia size (P < 0.05), and wound healing disorders (P < 0.05). The results of multivariate logistic regression revealed that the body mass index, type of tension-free repair, hernia size, and wound healing disorders were the independent risk factors associated with recurrence following incisional hernia tension-free repair. Fifteen recurrent patients were reperformed successfully. There was no recurrence following up with an average 23 months. ConclusionsIt is necessary to become familiar with the risk factors for recurrence of incisional hernia in order to eliminate or decrease their effects on the positive outcome of incisional herniorrhaphy. The patients with fat, hernia ring bigger, incorrect opera-tion or wound healing disorders might be easy to relapse. Surgical approach should be individualized for recurrence.