Background: Multiple techniques were clarified for mesh placement in the hernia repair surgery including onlay, sublay, and inlay positioning. Meshes with a dual-layer have been developed to prevent the formation of adhesions of the viscera to the intraperitoneal mesh. So, the present investigation was claimed to compare the outcome of the ventral hernia repair using inlay ventralex hernia patch with the classic onlay prolene mesh. Methods: A randomized clinical trial was carried on 60 patients with a ventral hernia in the department of General Surgery, Zagazig University Hospitals, Egypt from January 2018 to January 2020. The patients were equally divided into 2 groups; group A with inlay ventralex hernia patch and group B with onlay prolene mesh. Results: As regarding demographics and clinical presentation no statistically difference was found between both groups, while there was a highly significant differences between Group A and Group B in the operative time with mean 35.4±0.25 and 50.2±0.14 min with no significant difference between them in anesthesia type, defect size, and mesh size. On comparing the postoperative complications, a significant difference was found between them regarding wound seroma, wound infection, and postoperative pain. Also, highly significant shorter hospital stay, time of return to work or normal activity, and mean postoperative follow-up were observed in Group A. Conclusions: The inlay ventralex hernia patch is effective and easier technique and can also save the operative time with less postoperative complications and better outcomes as compared with the classic onlay prolene mesh. So, it’s using is considered cost-effective.