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Selection of mesh for ventral hernia repair and abdominal wall reconstruction can be challenging. Since the adoption of a tension-free mesh repair, the recurrence rates and outcomes after ventral hernia repair have substantially improved. The market for medical prostheses is constantly changing, with new technology in development attempting to create the ideal mesh for each clinical scenario. Permanent mesh is typically used for clean wounds. The various mesh materials, density, and pore sizes are discussed. In addition, the materials commonly used for contaminated wounds (absorbable synthetic and biologic meshes) are described. The latest literature regarding the use of various mesh materials is reviewed and organized to help make an informed decision regarding the appropriate use of reinforcing material.