The use of mesh has become standard in abdominal wall hernia repair. Infection of the implanted mesh in surgery of hernias and other major and complex abdominal wall reconstruction is one of the most significant consequences of this type of surgery. In most cases antibiotics and mesh-saving conservative operations may not be sufficient to eradicate the infection thus require mesh explanations, resulting in additional surgery, morbidity, and significant cost. How surgeons should approach this serious issue is the topic of this chapter.