Background: Incisional hernia accounts for 15-20 percent of all abdominal hernias. The two operative techniques most frequently used in case of incisional hernia are the onlay and sublay repair. However, it remains unclear which technique is superior. Aim: To compare onlay versus sublay technique in treatment of incisional hernia in term of outcome. Materials and Methods: The present descriptive observational study was carried out in patients admitted in surgical wards who are clinically diagnosed to have incisional hernia. The study was carried out for 10 months and follow up continued after that till date. Follow-up was done after every three months. 35 patients were managed by onlay (Group A) mesh repair and 35 patients were managed by sublay (Group B) mesh repair. Data collected in both groups was made in regards to operation time, placement and duration needed for drain removal, wound infection, and recurrence rate. Results: Wound infection was found in one patient (1.66%) in sublay group while 6 (10%) in onlay group. In onlay group recurrence was found in 4 patients (6.66%) while there is no recurrence in the sublay group. In sublay group seroma formation was found in two patients (3.33%) while 12 (20%) in onlay group. Conclusion: In our study, sublay mesh repair was found better alternative for surgical treatment of incisional hernia as compared to onlay mesh repair due to less post-operative complications.