Background: Incisional hernia is defined as any abdominal wall gap with or without bulge in the area of a postoperative scar perceptible or palpable by clinical examination or imaging [1]. Surgical management of incisional hernias has evolved over the last century, but consensus is lacking. Aims and objectives: This study aims to analyze the etiological factors of incisional hernia, modes of presentation, therapeutic modalities and the immediate postoperative complications. Materials and methods: The study is a prospective study conducted at a tertiary care teaching hospital for over 18 months. Thirty patients were studied and followed up for immediate post-operative complications. Observations and Results: Incisional hernia was found to occur more often in the 5th decade, females, and housewives, obese. The incidence was higher following gynecological operations, lower abdominal incisions, transverse incisions and when there was post-operative wound infection following the index surgery. Most patients noticed the incisional hernia only 1 to 3 years after the index surgery. A combination of mesh repair along with anatomical repair was carried out in 23 of the 30 patients, anatomical repair alone in 6 patients and one patient underwent laparoscopic mesh repair. Conclusion: Incisional hernias occur more often in females as they are more likely to undergo lower abdominal surgeries. Mesh repair was deemed superior to anatomical repair alone as post-operative complications were lesser. Placement of suction drain played an important role in reducing the likelihood of post-operative wound complications. There were no recurrences during our follow up period, albeit a longer follow up is required to draw definitive conclusions.