Background: Emergency ventral hernia repairs are commonly performed with either mesh or primary stitch repair. There is debate regarding the safety of mesh use when bowel resection is required. This study aims to evaluate the outcomes of emergency ventral hernia repairs. Methods: A retrospective cohort study was conducted on adult patients who underwent emergency ventral hernia repair from October 1, 2020, to October 31, 2023. Electronic records were utilized for data collection. Results: During this period, 398 patients underwent emergency ventral hernia repairs, with a median age of 62 (IQR 45-75) and 61% being male. Inguinal hernias accounted for the majority (37%) of repairs. Mesh was utilized in 76% of cases. While wound infections did not significantly differ between mesh and stitch repair, there was a statistically significant difference between resection and no resection groups (18% vs. 6%, P-value 0.028). Among the 7% of hernias requiring bowel resection, 28% were repaired with mesh. Notably, only one mesh repair required mesh explantation due to infection. Among the 72% receiving stitch repair, 3 experienced recurrence. Conclusion: This study concludes that mesh can be safely used in emergency ventral hernia repairs. Although an elevated risk of wound infection is noted, mesh infection necessitating explantation remains a rare occurrence. These findings contribute valuable insights for clinicians navigating the choice between mesh and stitch repair in emergency settings.