Operations on the abdominal wall are increasingly prevalent, with a rising number performed on patients presenting significant co-morbidities and complex hernia conditions. These co-existing medical conditions profoundly influence surgical outcomes, impacting both quality of life and healthcare costs. Numerous studies indicate that optimizing controllable co-morbidities through preoperative interventions (prehabilitation) yields positive clinical outcomes. While factors like nicotine consumption and obesity are modifiable, others may necessitate specific treatments to mitigate complication risks. Understanding the physiopathological impact of co-morbidities on the healing process elucidates the causal links between individual conditions and heightened risks of mesh infection, wound healing issues, and recurrence. Adopting multidisciplinary approaches and involving patients in their care can significantly reduce morbidity. This chapter addresses the most prevalent controllable co-morbidities and offers recommendations for appropriate prehabilitation strategies.