Very elderly patients (76-90) show comparable outcomes to younger counterparts after ventral hernia repair.

• No differences in 30-day mortality, readmissions, or complications.
• Very elderly patients reported higher quality of life scores at baseline and significant improvements at 30 days and 1 year.

Surgeons can confidently include very elderly patients in surgical plans, as they achieve significant quality of life gains post-operatively.

• Lower pain scores at 30 days in the very elderly cohort indicate a better pain experience.