After review and evaluation of current clinical data, including significant wound complications, a noteworthy failure rate at 1 year, and high product costs, it is difficult to support the continued use of biologic meshes in incisional hernia repair outside of well-designed and rigorously conducted clinical trials. An industry-sponsored, publicly available registry of biologic prosthetic use for ventral hernia repairs is needed. This straightforward mandate, if properly constructed and implemented, would significantly expand knowledge regarding how these intriguing biomaterials are used and their overall clinical efficacy, thus yielding a more robust basis for the continued use of biologic prosthetics in hernia repair than is currently available.