Since the guidelines recommend the laparoscopic approach as the first option in ventral hernia repair, minimally invasive techniques have been improved due to significant changes of the paradigm in abdominal wall reconstruction (AWR): from bridging the defect—the laparoscopic IPUM technique to the restoration of the linea alba, closure of the defect, and placement of the mesh as augmentation—“IPUM plus.” The evolution of the techniques in ventral hernia repair continued to improve; surgeons have tried to obtain better and better results, restoring the functionality of the abdominal wall and pushing the mesh outside the abdominal cavity. The enhanced-view totally extraperitoneal (eTEP) retro-rectus repair combines the advantages of minimally invasive surgery (MIS) with the principles of Rives–Stoppa procedure as the gold standard in open ventral hernia repair. The (eTEP) technique has been previously described for laparoscopic inguinal hernia repair. Since this access was also used in ventral and incisional hernias repair, eTEP became a well-known acronym. The purpose of this chapter is to describe in detail the eTEP retro-rectus repair and also the indications, limitations, and contraindications of this technique. The selection criteria of the cases and also pre-and postoperative management represent important issues in order to achieve the best results.