Aim. To present an experience of treatment of children with large hernial defects of the anterior abdominal wall. Material and methods. This article describes management of 43 children with large (n=31) and giant (n=12) ventral hernia who were at N.F. Filatov Children´s City Hospital №13 for the period 2005—2015. All patients underwent surgical correction using local tissues in «edge to edge» fashion (n=23), aponeurosis dublication of «coat floors» type (n=14) and biological implant «Permacol» (n=6). Etiological causes of ventral hernias in children were comprehensively analyzed. Optimal time for surgical treatment and features of viscero-abdominal disproportion were discussed. Conclusion. Early restoration of anatomical and functional structures of the anterior abdominal wall is necessary for good cosmetic result and prevention of recurrent ventral hernia. We presented three clinical examples of commonly used surgical procedures in children including anterior abdominal wall repair using biological material «Permacol».