Obese patients present a unique challenge in ventral hernia management. The rising prevalence of obesity compounds this challenge, as increased BMI correlates with higher perioperative risks and recurrence rates. This chapter reviews the complexities of treating hernias in obese patients, highlighting interdisciplinary strategies and the role of robotic-assisted surgery in improving outcomes. Obesity is an epidemic that has dramatically increased the incidence of ventral hernias complicating surgical intervention due to the heightened risk of perioperative complications and recurrence. Given the growing burden of morbid obesity and its associated comorbidities, managing hernia repairs in these patients necessitates a comprehensive, multidisciplinary approach. This chapter discusses the challenges and approaches in managing ventral hernias in obese patients, emphasizing the importance of personalized treatment plans. For emergency cases, hernias should be treated according to the surgeon’s expertise. However, in elective cases, a more nuanced decision is required. The choice between prior bariatric surgery, simultaneous hernia repair, or staged procedures depends on patient-specific factors. Recent advances in robotic hernia surgery offer significant benefits, particularly in allowing extraperitoneal mesh placement, which reduces complications.