Mesh infection after abdominal wall reconstruction is a complex and costly problem. Preventing this problem in the first place is paramount; based on available evidence, we present the risk factors and measures to prevent such an infection. When it occurs, the treatment of infected mesh spans a wide spectrum of options, starting with mesh preservation and antibiotic coverage to a more aggressive surgical debridement, mesh explantation, and repeat reconstruction. Specifically, we assess the impact of mesh type and wound classification at the time of original repair and how they affect decisions in the handling of a subsequent mesh infection. This chapter covers the various treatment strategies available to the surgeon, taking into consideration patient risk factors, mesh types, and wound status.