Background and purpose Aggressive fibromatosis (AF) is a relatively rare borderline tumor with a tendency for local invasion but generally lacking distant metastasis. It is associated with a high recurrence rate. For patients with abdominal wall AF, achieving radical resection often requires disrupting the integrity of the abdominal wall, making abdominal wall reconstruction after tumor resection a challenging task. This study was performed to investigate the safety and efficacy of radical resection combined with artificial material bridging for the treatment of abdominal wall AFMethods The clinical and follow-up data of 16 patients with abdominal wall AF treated in the Department of Geriatric Surgery, the Second Xiangya Hospital of Central South University, from January 2013 to October 2021 were retrospectively analyzed. All patients underwent one-stage radical resection of the abdominal wall lesion and simultaneous repair of the abdominal wall defect with artificial material bridging.Results The average operative time for the 16 patients was 98 (70-235) min, and the average tumor size was 8.6 (4-14) cm. After tumor resection, abdominal wall defects ranged from 6 cm × 8 cm to 14 cm × 19 cm. Abdominal wall defects were repaired and reconstructed using artificial materials, with 6 cases using sublay bridging, 9 cases using IPOM bridging, and 1 case using three-dimensional bridging. All surgeries were completed successfully. Postoperative pathology reports confirmed AF in all cases, with one male patient showing a CMNNB1 exon 3 (T41A) mutation. One patient developed postoperative seroma, which was successfully treated with vacuum-assisted closure (VAC) after open wound management, and healed after secondary closure. The remaining 15 patients experienced no serious postoperative complications, such as wound infections, mesh infections, or intestinal obstruction, and were discharged after achieving grade I wound healing. The median follow-up period was 46 (12-110) months, with a 100% follow-up rate. No tumor recurrence, chronic pain, mesh-related infections, mesh protrusion, or incisional hernia occurred during the follow-up period.Conclusion Abdominal wall AF can occur in different parts within the muscle layer of the abdominal wall and typically presents as a local mass. Surgical treatment is the primary therapeutic approach. Complete tumor resection with negative margins effectively prevents tumor recurrence. Therefore, preoperative assessment of tumor size, depth of invasion, defect location, and extent is crucial for designing individualized surgical approaches to achieve effective abdominal wall reconstruction in terms of both form and function. Radical resection combined with artificial material bridging repair for post-resection abdominal wall defects is a safe and effective treatment for abdominal wall AF.