Unfortunately, neither new operation techniques nor advancements in mesh development could change the fact that chronic pain remains the most severe postoperative complication in open and laparoscopic hernia surgery. The main reason seems to be nerve injury due to mesh fixation. New fixation techniques like fibrin sealing, self-fixating meshes and no fixation have replaced conventional traumatic fixation devices. The guidelines by the European Hernia Society and the International Endoscopic Hernia Society represent for the first time a publication of evidence-based data. This review illustrates a practical overview of open and laparoscopic fixation techniques based on these guidelines and up to date studies.