Frequent and well known pathology, umbilical hernias are different if they occur in children or adults. Embryology and anatomy are necessary to understand all mechanisms which can explain a weakness or non complete closure of the umbilical ring. An umbilical hernia during infancy, is congenital. The diagnosis is easy, as well as its surgical treatment, usually without recurrence. In adulthood such an hernia has an acquired origin. Its treatment is often more complex, especially in obese middle-aged multiparous women, and cirrhotics. The most important is to choose the right time for surgery before complications occur: strangulation or umbilical ruptures in cirrhotics, above all with ascites. In these cases, the rate of morbidity and mortality is high, and recurrences as well.