Despite the progress concerning operative techniques, parastomal hernias remain a surgical challenge. The high risk for recurrence demands precise indications for operative repair. Mesh implants reduce the recurrence rate. Among such procedures, the retromuscular mesh augmentation represents an established method, whereas the value of other techniques still has to be defined. Also, the prophylactic use of meshes is able to reduce the incidence of parastomal hernias. With regard to short- and long-term complications, their general recommendation must be proven in further studies.