Background: Female patients of reproductive age constitute a substantial portion of patients undergoing ventral hernia repair, however the impact of pregnancy on the risk of recurrence is scarcely documented. The aim of the study was to evaluate if pregnancy following ventral hernia repair was associated with an increased risk of recurrence. Methods: This nationwide cohort study included all female patients of reproductive age registered in the Danish Ventral Hernia Database with ventral hernia repair between 2007 and 2013. The primary outcome was ventral hernia recurrence. Multivariable extended Cox regression analysis was performed. Results: A total of 3578 patients were included in the study, 267 (7.5%) of whom subsequently became pregnant during follow-up. The median follow-up was 3.1 years (range 0-8.4 years). Pregnancy was independently associated with recurrence (hazard ratio 1.56, 95% confidence interval 1.09-2.25, P = 0.016). Conclusions: Pregnancy after ventral hernia repair was independently associated with ventral hernia recurrence. Summary: Female patients of reproductive age constitute a substantial portion of patients undergoing ventral hernia repair, however the impact of pregnancy on the risk of recurrence is scarcely documented. In this cohort study based on nationwide Danish registries, we found that pregnancy after ventral hernia repair was independently associated with an increased risk of ventral hernia recurrence.