Abstract Aim Α giant hiatal hernia is defined as a type III paraesophageal hernia, where more than 30% of the stomach lies within the thoracic cavity, with or without any other abdominal viscera, such as pancreas, spleen, or colon. It suggests a rare clinical entity, accounting for less than 0,3% of all hiatal hernias. As a consequence, the surgical treatment, and in particular the laparoscopic approach, is considered challenging and demanding. The purpose of this study is to prove, through our center's experience, that the laparoscopic approach is a safe and effective method of giant hiatal hernia repair. Material and Methods 8 patients, 4 men and 4 women, 63,83 years old on average, with giant hiatal hernias, are included in this study. In all cases, laparoscopic hiatal hernia repair was performed, without any conversions, in combination with Nissen fundoplication. In addition, in three cases, a poly-4-hydroxybutyrate mesh (Phasix) was applied. Results Two patients were reoperated, one due to persistant dysphagia and one due to ileus. The rest of the patients followed an uneventful postoperative course with a short hospital stay and elimination of their symptoms, during a 12-month follow-up period. Conclusions Laparoscopic repair of giant hiatal hernias suggests is a challenging operation, which is accompanied by high morbidity and recurrence rates, up to 12% and 10% respectively, as reported in the literature. However, it is a safe and effective procedure when performed in experienced centers.