Although the use of synthetic meshes has dramatically decreased the recurrence rate after the treatment of hernias of the abdominal wall, we know that their use in a setting of contamination or in certain locations can lead to specific complications such as mesh infection or erosion. To overcome these problems, a completely new generation of so-called remodelling biological scaffolds from human or animal origin or even new synthetic constructs have been promoted in recent years. Despite the fact that these materials might be useful in certain conditions, the evidence from high-quality studies, preferably with an adequate control group, is low. This issue of Hernia bundles 11 papers on this intriguing subject, together with a critical invited comment by Dr. Agneta Montgomery. In this way, the editors of Hernia want to offer their readers a balanced state-of-the-art picture on this controversial topic anno 2013.