Objective: To compare the post-operative pain, post-operative complications, hospital stay and rate of recurrence in two group of mesh repair and anatomical repair in para-umbilical hernia. Material and Methods: This comparative study was conducted in Department of Surgery unit-I at Liaquat University Hospital Jamshoro. Sixty two cases of par umbilical hernia were collected from 2008 to 2010, were randomized in two groups, 32 for mesh repair and 30 for anatomical repair. All patients of para umbilical hernia were admitted throughout patient department. Those patient having irreducible hernia, defect in Lenia alba less than 4 c.m and patient unfit for general anesthesia were excluded from study. Results: Majority of patients 50% belong to age of 41 to 55 years and 91.9% were female. Supra umbilical swelling was the commonest presentation 82%. Cough impulse and reducibility was positive in 100% of cases. Contents of sac were omentum in 66% to 88% and small intestine 31% to 33% operative time was longer in group one (mesh repair) ranged from 55 to 85 minutes while that was 45 to 75 minutes in group two anatomical repair. There was no recurrence observed in group one but three cases of group two suffered from the recurrence in which mesh was applied during 2nd surgery. The mean hospital stay for group one was 5.5 days and for group was 6.5 days. Conclusion: Mesh repair is with less post-operative pain, less hospital stay and less recurrence for large para umbilical hernia of defect more then 4 c.m in len0ia alba.