Materials and methods: A prospective randomized control trial was undertaken with 50 patients undergoing elective laparoscopic ventral hernia repair. The patients belonging to group I (n = 25) received 15 mL of 0.25% bupivacaine on both sides by ultrasound guidance at the end of the procedure, whereas those in group II (n = 25) received the same under laparoscopic guidance at the end of the procedure. Postoperative pain scores were measured using visual analog scale (VAS) both at rest and during motion at 0, 2, 4, 6, 12, and 24 hours postoperatively. Other parameters like the administration of first dose of rescue analgesic and time required for postoperative ambulation were also recorded. Aim: To assess and compare the postoperative analgesic effect of laparoscopy-guided transversus abdominis plane (TAP) block vs ultrasound-guided TAP block in patients undergoing Laparoscopy-assisted ventral hernia repair. Results: Demographic data, duration of surgery, and size of the hernial defect were comparable in both the groups. The total intraoperative opioid consumption was also similar in both the groups (p = 0.740). The pain scores at rest as well as during motion were comparable at all points between the two groups. The time required for the administration of first dose of rescue analgesic as well for postoperative ambulation was also similar in both the groups. Conclusion and clinical significance: Our study establishes that laparoscopy-guided TAP block is an effective modality to provide analgesia for patients undergoing laparoscopy-assisted ventral hernia repair. Ultrasound-guided TAP block has been long established as an effective modality in providing postoperative analgesia. However, the nonavailability of ultrasound machines in operating rooms especially in developing countries like ours limits its use in a perioperative setting. Laparoscopyguided TAP block might be as effective, easier, and probably less time consuming than ultrasound-guided TAP block.