The recurrence rate after laparoscopic primary repair of giant hiatal hernias with paraesophageal involvement is reported to be high. Meshreinforcement repair of hiatal defect is proposed for solving this problem which is debated. The indication for mesh use, the type of meshto use, and the placement technique are controversial. After review of all literatures of our study it has been concluded that the use ofprosthetic reinforcement of cruroplasty in laparoscopic giant hiatal hernias has very low recurrence, though certain mesh relatedcomplications are worse than recurrance which are up to certain extent are surgically correctable complications, as per different studiesno one mesh type is clearly superior in terms of avoiding failure and complication. Only further studies and long-term evaluation will allowjudgment of the effectiveness of laparoscopic mesh repair in patients with large hiatal hernias.