The treatment of incisional hernia has always been a difficult problem in abdominal wall surgery because there are still many issues that have not been clarified and resolved. To deepen the understanding of incisional hernia, we need to start with its essence, occurrence, and the principle of its occurrence and development, which cannot be separated from the exploration of the structure and mechanical characteristics of the abdominal wall. In addition, the abdominal wall is a complex organ with multiple functions, and surgical techniques need to focus on its functions in order to achieve to unity of "from structure to function". Here, the authors discuss relevant issues from multiple perspectives such as "functional unit of abdominal wall", the development of incisional hernia under mechanical action, the mechanical characteristics of the abdominal wall, and the functional characteristics of the abdominal wall, address some issues in current incisional hernia surgical techniques, and propose the directions and strategies for improvement, with the aim of enhancing surgeons' understanding of incisional hernia for better use and innovation of abdominal wall surgery techniques.