Background and Aims Single-incision laparoscopic surgery (SILS) has been widely utilized in abdominal surgeries, but its application in umbilical hernia repair has been limited. Building on the department's prior experience with single-incision laparoscopic inguinal hernia repair (TEP), the authors attempted to treat adult umbilical hernias using single-incision laparoscopic totally extraperitoneal sublay (SIL-TES) and gained certain experience. This study was to explore the feasibility and efficacy of SIL-TES for the treatment of adult umbilical hernia.Methods The data from 13 adult umbilical hernia patients who underwent SIL-TES in Quanzhou First Hospital Affiliated to Fujian Medical University from January 2021 to August 2022 were retrospectively analyzed. Among these patients, there were 9 males and 4 females, with an average age of (38.9±6.1) years and an average hernia ring diameter of (2.4±0.6) cm. The requirements of SIL-TES included: building upon the three-port laparoscopic totally extraperitoneal sublay as the foundation, incorporating the techniques of single-incision laparoscopy, achieving seamless coordination between the camera-holding assistant and the primary surgeon, placing the laparoscope and instruments logically to minimize the "chopstick effect" during the procedure; proficiency in mastering the multi-layer anatomy of the abdominal wall for avoiding intraoperative anatomical errors and peritoneal damage, ensuring the mesh placed in the correct layer.Results All 13 cases were successfully completed without any conversions to open surgery. The average operative time was (138.5±20.9) min, with an average postoperative pain score of 2.5±0.9 at postoperative day 3. The mean duration of postoperative drainage tube placement was (4.1±1.1) d. The average length of postoperative hospital stay was 3 to 6 d, with a median length of 4.1 d. No complications such as seroma, bleeding, wound dehiscence, wound infection, umbilical skin necrosis, bowel obstruction, or bowel fistula occurred. The average follow-up duration was (14.7±6.3) months, and no cases of hernia recurrence or chronic pain occurred.Conclusion The use of SIL-TES for the treatment of adult umbilical hernia is feasible and can serve as a supplementary surgical option. However, due to the limited number of cases and short follow-up duration, the long-term effectiveness of this approach requires further clarification.