Background: Midline laparotomy is a common surgical procedure in various specialties. The closure technique used for the abdominal wall following midline laparotomy plays a crucial role in optimal wound healing and reducing complications. Historically, layered closure has been the gold standard, but it can be time-consuming and may increase the risk of complications. The retention closure technique, involving the use of mesh or synthetic material, has emerged as an alternative. Some studies suggest that retention closure may reduce wound complications and incisional hernias. This study aims to compare the outcomes of layered closure and retention closure techniques, including wound healing, hernia rates, surgical duration, and patient satisfaction, to guide optimal abdominal wall closure in midline laparotomy. Methods: A retrospective analysis was conducted on 134 patients who underwent midline laparotomy at a tertiary care center, North Wales, UK. The study compared layered closure and retention closure techniques. Data on patient demographics, closure techniques, and postoperative outcomes were collected from electronic medical records. Primary outcomes included wound complications and incisional hernias, while secondary outcomes included surgical duration, hospital stay, and patient pain scores. Statistical analysis was performed using SPSS, and significance was set at p<0.05. Results: In our study, there were no statistically significant differences observed between the two groups in terms of age (39.23±12.65 years in the layered suturing group vs. 43.83±11.81 years in the retention closure group, p=0.079). In our study, male predominance was observed in both the layered suturing group (62.8%) and retention closure group (71.7%). In the present study, the incidence of Burst abdomen (dehiscence) was 4.7% in the layered suturing group compared to 2.2% in the retention closure group. In the present study, the incidence of Surgical Site Infections (SSIs) was 14.0% in the layered suturing group compared to 4.3% in the retention closure group. Conclusion: In conclusion, the present study demonstrates that the retention closure technique for abdominal wall closure in midline laparotomy offers several advantages over the traditional layered suturing technique.