Open sublay and laparoscopic IPUM repair have specific disadvantages and risks. In recent years, this evidence induced the development of new minimally invasive techniques with extraperitoneal mesh repair. Pioneering this trend, we developed the endoscopically assisted mini- or less-open sublay (MILOS) repair. The operation is performed transhernially via a small incision with light-holding laparoscopic instruments either under direct or endoscopic visualization. After dissection of an extraperitoneal space of at least 8 cm, port placement and CO2 insufflation, each MILOS operation can be continued endoscopically (EMILOS repair). From its inception, all E/MILOS operations were prospectively documented in the German Herniamed Registry. In our hands, the E/MILOS concept allows the minimal invasive sublay mesh repair of almost all ventral and incisional hernias with low complication, recurrence, and chronic pain rates. In large ventral and incisional hernias and non-midline eventrations, E/MILOS-TAR can be performed. The EMILOS operation is the preferred option for ventral hernias with concomitant Diastasis Recti. Giant hernias with loss of domain are not suitable for the E/MILOS approach.