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Incisional hernia is a common post-surgical complication, but hernias through iliac bone defects after the harvesting of an iliac bone graft is rare. The common presentation includes swelling and discomfort, and sometimes features of intestinal obstruction. A computerized tomography (CT) scan is commonly used for the diagnosis and to define the anatomical defect in the bone. Surgery is recommended because of high risk of strangulation. While various methods of repairing this type of hernia have been described, we chose to perform mesh repair for an iliolumbar incisional hernia.