Ventral abdominal wall hernias (VH) are surgically challenging as they are generally associated with an increased chance of recurrence and wound complications. VH are surgically managed by the following techniques—primary repair, hernioplasty, flap technique, or abdominal wall component separation technique (CS). The methods of component separation technique have progressed significantly since Ramirez et al. popularized its use in 1990. Component separation can be anterior component separation (ACS) or posterior component separation (PCS) supplemented by transversus abdominis muscle release (PCS-TAR); it can be performed by open or endoscopic approaches. Any large hernia >8 cm will need release of the myofascial layer to approximate the tissues for a midline closure in a tension-free manner. In addition to closure of the midline by posterior rectus sheath approximation, it importantly allows medialization of the abdominal wall components for achieving a tension-free repair, avoiding large lipocutaneous flaps and its complications as needed in anterior component separation technique. PCS-TAR technique is a reliable and safe technique for repairing large ventral hernias. When performed endoscopically, it provides all benefits of minimally invasive surgery along with the benefit of placing a bigger retrorectus mesh to provide a durable repair with least risk for recurrence.