ackground: There are wide range of pathology affecting the anterior abdominal wall which range from simple fluid collection to hernias to complex neoplasms. Anterior abdominal wall hernias are the most common lesion of anterior abdominal lesions. The aim of the present study was to evaluate high-resolution sonography and colour Doppler in assessment of complicated anterior abdominal wall hernia. Patients and methods: This study includes (48) patients were referred for sonography due to vomiting and abdominal pain of unobvious cause. Patients were subjected to full clinical examination and high-resolution Ultrasound and Doppler examination and X-Ray for intestinal obstruction if needed. Results: Mean defect size of hernia associated with bowel ischemia was 1.3±0.85 cm while the bowel wall thickness mean was 4.1 ±0.3 mm, in contrary, the mean defect size of hernia with non-ischemic bowel was 2.9 ±0.65 cm and the bowel wall thickness mean was 2.2 ±0.89 mm. Among the studied group, Reduction of viable loops and herniorrhaphy were done in 45.8 % of patients, Reduction of viable loops and hernioplasty in 22.9% of cases, while resection and primary anastomosis were done in (14.6) of cases. The ultrasound finding comparing with the operative data revealed that ultrasound had 100% sensitivity, while accuracy in diagnosis of peristalsis, bowel irreducibility, bowel thickness was ranged from 93.4% to 98.8%. Also Doppler accuracy was 100% Conclusion:High-resolution ultrasonography (US) is non-invasive, safe and effective and simple diagnostic tool for detecting the presence of abdominal wall hernias and accurately detecting the contentand the possible associated complications.