Mesh infection complicated by enteric fistula following incisional hernia repair constitutes a life-threatening complication, which often results in prolonged non-healing of the abdominal wall incision and significantly impairs patients' quality of life. This case report presents a patient with an incarcerated incisional hernia, in whom intraoperative exploration revealed necrosis of the incarcerated intestinal segment. Simultaneous resection of the necrotic intestine and mesh repair of the hernia were performed during the same operation. Postoperatively, the patient developed an incision infection and subsequent mesh infection, which eventually progressed to enteric fistula and recurrence of incisional hernia. The disease course lasted for 4 years, and the patient achieved complete recovery following reoperation. This case aims to enhance clinicians' understanding of such complications and provide valuable reference for their clinical management.