Objective To evaluate effect of massive and complex incisional hernia or defect of abdominal wall by using prosthetic mesh. Method The clinical data of 112 patients with massive and complex incisional hernia or defect of abdominal wall from February 2003 to February 2016 were analyzed retrospectively. Results Sixty-three cases were repaired by placing artificial mesh between the peritoneum and the musculus rectus abdominis and 49 cases by opening intraperitoneal mesh placement. The primary healing occurred in 108 cases, the incision infection occured in 4 cases, the seroma occurred in 7 cases. The stretched feeling was found in 39 cases and the mild pain occurred in 17 cases in the operative area at early term after operation. One hundred and two patients were followed up for 9–156 months (mean 78.6 months), the recurrence was observed in 3 cases (2.94%). Conclusion Repair of massive and complex incisional hernia or defect of abdominal wall by using prosthetic mesh has some advantages of minimal invasiveness, rapid convalescence, and low recurrent rate.