PURPOSE: Perineal hernia(PH) is a complication after abdominoperineal resection(APR), which is a special kind of incisional hernia, lacking consensus about treatment. This study is aimed at the effect of laparoscopic repair with mesh. METHODS: A retrospective study was conducted from Januarary 1st 2015 to December 31st 2023 for the patients undergoing laparoscopic perineal hernia repair after abdominoperineal resection(APR). The data of characteristics, surgery details and follow-up were collected and analysed to evaluate the effect and complications. RESULTS: 41 cases were included altogether and all patients received laparoscopy approach, 14 males and 27 females, median age was 70 years(range 45-80years), the mean BMI was 25.04 ± 3.38 kg/m CONCLUSION: Laparoscopic perineal hernia repair with mesh shows low rates of complications, which is a safe and effective method to perineal hernia after APR. For large defects, hybrid technique helps to close the defect and eliminate dead spaces. The appropriate kind and adequate mesh overlap are critical. Short-term follow up shows positive outcomes in this retrospective study and the controlled trial and long-term follow-up is needed in the future.