Objective To discuss our experience in repair of huge ventral incisional hernia with Initiative Volume Reduction Surgery.(IVRS).Methods From January 2011 to January 2013, we performed IVRS in 26 cases of huge abdominal incisional hernia with acellular tissue matrix (ACTM) grafts which had the ability to withstand infection.Results The procedure was completed in all the 26 cases, with a mean operation time of (121.3±17.9) minutes, range from 95 to160 minutes.The mean intraoperative blood loss was (65.3±28.4) ml, range 30 to 200 ml.About 150 to 350 cm intestine was resected in these patients, a mean of (212.6±38.3) cm.The Intra-abdominal Pressure (IAP) during the first week after surgery was monitored, with mean of (7.8±2.1) mmHg, range from 5.2 to10.7 mmHg.After the operation, the patients was discharged from our hospital in 9 to 20 days with a mean of (14.2±3.3) days.Two of the patients had postoperative wound infection without anastomotic leak or abdominal organ injuries.We followed up all the patients for (28.1±5.2) months (range 18 to 42months).A case of recurrence was observed.Conclusions IVRS is safe and effective for huge ventral incisional hernia associated with loss of abdominal domain.It can reduce postoperative intra-abdominal pressure (IAH), and to avoid the occurrence of abdominal compartment syndrome (ACS), which finally can reduce the rate of postoperative complications and recurrence rate.