Background and Aims The concept of minimally invasive repair of incisional hernia has reached a certain consensus in the field of hernia surgery. Laparoscopic incisional hernia repair is becoming more popular in clinical practice, but endoscopic mesh fixation technique is still a difficult issue. This study was to introduce a new method of incisional hernia mesh fixation and evaluate its clinical application effect.Methods The clinical data of 120 patients undergoing laparoscopic incisional hernia repair (IPOM) in the Department of Gastroenterology, Hernia and Abdominal Wall Surgery of the Sixth Affiliated Hospital of Sun Yat-sen University from January 2018 to December 2019 were retrospectively analyzed. Of the patients, the "contraposition and alignment" mesh fixation was used as the mesh fixation method in 60 cases (observation group), and the traditional mesh fixation method of double-crown tacker fixation was used in the other 60 cases (control group). The relevant clinical variables and economic indexes of the two groups were compared.Results There were no significant differences in gender, age, BMI, course of disease and the maximum diameter of the defect of the hernia between the two groups (all P>0.05). Compared with control group, the mean mesh fixation time was shortened (35.5 min vs. 47.7 min, P<0.05), the mean number of hernia tackers used for fixation was decreased (36.6 vs. 44.2, P<0.05), the mean VSA score of postoperative pain was lowered (3.2 vs. 4.6, P<0.05), and the hospitalization cost was reduced (39 000 yuan vs. 48 000 yuan, P<0.05) in observation group. There were no significant differences in incidence rates of seroma formation and mesh infection as well as the length of postoperative hospital stay between the two groups (all P>0.05). The average follow-up time for observation group and control group were 26.3 and 25.8 months, respectively. No significant differences were noted between observation group and control group in recurrence rate of incisional hernia (1.7% vs. 5%, P=0.61) and the incidence of postoperative chronic pain (6.7% vs. 8.3%, P=1.00).Conclusion The "contraposition and alignment" mesh fixation could shorten the mesh fixation time, reduce the number of hernia, save hospitalization costs, and reduce the occurrence of early postoperative pain after incisional hernia. The application of this method in laparoscopic incisional hernia repair is safe and effective, and can be widely used in clinical practice.