Intraperitoneal underlay mesh (IPUM) technique, commonly referred to as intraperitoneal onlay mesh (IPOM) technique, has been used for decades to allow for minimally invasive repair of ventral hernias. Though there are many people who have abandoned this technique for more contemporary approaches (e.g., TAPP and retromuscular approaches), it can serve as a great option in a variety of circumstances. This video reviews the approach and some of the reasons why I still maintain it as an element of my practice.