A retrospective comparison of 2830 patients with midline abdominal incision closures was made. Dehiscences, infections, hernias were compared examining continuous mass closures (group A) versus interrupted mass closures (group B) and interrupted layered sutures (group C). The three groups were well matched for known risk factors for each of the above complications. Mass closures produced a significant higher number of infections (p = 0.0006) and hernias (p = 0.0001). There was no significant difference in the rate of dehiscences in the three suture groups (p = 0.07). A significant correlation was found in all three groups between the incidence of infections and that of outcoming incisional hernias. In the current study layered closure of the of the midline abdominal wounds yielded better results when compared with both running mass and interrupted mass closures. The knowledge of these findings might help when choosing the procedure to close a midline abdominal incision.