The use of linear cutting staplers in ventral hernia repair does not represent so much a different operative technique but rather a technical modification to facilitate the dissection of the retromuscular plane and simplify the midline crossover and closure required in retrorectus repairs. Originally described by Costa et al. in transabdominal retrorectus repair, linear cutting staplers have been utilized in conjunction with most common extraperitoneal repair techniques including eTEP (extended- or enhanced-view total extraperitoneal), MILOS (minimally invasive or less open sublay) and its endoscopic variant eMILOS, TES (total endoscopic sublay), VTEP (ventral total extraperitoneal), and open and mini-open variants of Rives-Stoppa repairs. Stapling accomplishes rapid and simplified takedown and crossover of the medial insertions of the posterior rectus sheaths, creates a unified retrorectus pocket, and plicates the midline with stapled reapproximation of the posterior sheath. Intraoperative tension and delayed posterior sheath disruption can result in complications including bleeding, mesh exposure, intraparietal herniation, bowel obstruction, and recurrence and remain the most important technical considerations with stapled retromuscular ventral and incisional hernia repair. Stapling can be a useful adjunct in eTEP retrorectus hernia repairs and in patients with coexisting rectus diastasis but has specific indications for smaller to mid-sized hernias with mild diastasis due to the technical considerations of stapler reach, efficacy, and staple line integrity.