Objective: To examine the safety and efficacy of laparoscopic hiatal hernia repair. Methods: The clinical data of 51 patients undergoing laparoscopic hiatal hernia repair from July 2012 to July 2016 were retrospectively analyzed. Results: In all the 51 patients, laparoscopic hiatal herniorrhaphy was uneventfully performed, and a mesh was used to reinforce hiatal closure during operation. Dor fundoplication was performed at the same time in those without obvious contraindications. The average operative time was (100±19.6) min, the average blood loss was (28±15.4) mL, and the average length of hospital stay was 2 d. The symptoms caused by compression of the hernia sac contents such as chest pain and choke after eating were significantly alleviated, and the reflux-related symptoms such as acid regurgitation and heartburn were significantly improved after operation. No serious complications occurred, and all patients returned to normal diet within four weeks after operation. Follow-up was conducted for an average of 32 months, and no recurrence or mesh-related complications were noted. Conclusion: Laparoscopic hiatal hernia repair is a safe and effective procedure, and mesh reinforcement after hiatal closure can reduce the recurrence of hiatal hernia.