Ventral hernia and primary ventral hernia have different meanings. In this article, primary ventral hernia refers to non-surgically induced hernias located on the anterolateral and posterior abdominal walls (excluding inguinal and femoral hernias). Patients with primary ventral hernias do not have surgical incisions and are more willing to undergo minimally invasive treatment. Meanwhile, their intact abdominal wall tissue is suitable for applying novel minimally invasive techniques. The therapeutic efficacy of primary ventral hernias is significantly better than that of incisional hernias. Currently, there are numerous minimally invasive procedures, each reflecting its own advantages in the treatment of primary ventral hernias. The laparoscopic intraperitoneal onlay mesh repair (IPOM) and the minimally invasive non-intraperitoneal mesh repair (MINIM) have different concepts but complement each other technologically, with the common goal of pursuing minimally invasive procedures and abdominal wall functional reconstruction. MINIM dominantly consists of various endoscopic extraperitoneal repair procedures (EER), most of which start from primary ventral hernias and gradually expand their indications. Another type of procedure is laparoscopic-assisted onlay repair, which plays a unique role in primary midline ventral hernias. Umbilical hernias, diastasis recti, primary supra-pubic hernias, Spigelian hernias, and primary lumbar hernias are commonly encountered types of primary ventral hernias. This article discusses each of them individually, elucidating their definitions, characteristics, and the progress of minimally invasive procedures.