Traditionally, the quality of ventral hernia repair has been measured by hard outcomes such as morbidity and recurrence, but patient-reported outcome measures (PROMs) have become increasingly popular. In this review we suggest, that only a minor subset of PROMs has improved in patients undergoing elective large-sized incisional hernia repair. For umbilical and smaller incisional hernia repairs, no significant evidence for improved PROMs was found. The vast majority of data were of questionable scientific methodology.