Background: There is still a furlong search for the ideal surgical technique for midline laparotomy fascia closure and the ongoing discourse on the issue is yet to arrive at a consensus due to conflicting, inconsistent and incomplete evidence being obtained from randomized controlled trials and even from meta-analyses. Objective: The objective of this study was to determine the outcomes of Continuous-in-three segments suturing and Interrupted suturing techniques for midline laparotomy mass wound closure in patients at Lagos University Teaching Hospital. Patients and Methods: This was a randomized prospective comparative study of one hundred patients who required exploratory laparotomy and fulfilled the inclusion criteria. The patients were recruited for a period of one year between May 2016 and 2017 with a follow up period of a year. All patients enrolled in the study had detailed clinical evaluation after which haematological, biochemical and radiological investigations were performed. Intra-operative diagnosis as well as the length of the fascia was documented for each patient. All patients were observed for early post-operative wound complications (surgical site infection and wound dehiscence) occurring within 30 days of operation and for late post-operative complication (incisional hernia) checked for at 3 monthly intervals after surgery. Results: One hundred patients were studied, five patients (5%) died during the follow-up period and fifteen patients (15%) were lost to follow up; eighty patients (80%) were available for analysis with forty patients each in group A and B. The age range was 18 to 74 years with mean age of 40.79±1.79 years. The common operative diagnosis was ruptured appendicitis (23%), adhesive small bowel obstruction (17.5%) and large bowel tumours (16.3%). The estimated time used during the Continuous-in-three segments technique was shorter than the time used in the Interrupted, but this difference was not statistically significant at p value 0.475. The three post-operative complications studied in the two groups were surgical site infection, wound dehiscence and incisional hernia. The incidence rate of development of surgical site infection in the study was high at 62.5% and there was no statistical difference between the two groups. With respect to wound dehiscence, only two patients developed fascia dehiscence, and this was in the continuous group, but this was not statistically significant at p value of 0.494. The Continuous-in-three segments had a higher number of patients with incisional hernia compared with the interrupted suturing technique and this was statistically significant at p value of 0.032. Surgical site infection was not found to be a statistically significant predictor of incisional hernia in this study but it was clinically significant as there was an increased number of patients with wound infection in the Continuous-in-three segment group and this could account for the higher rate of incisional hernia in this group. Various independent variables like obesity, anaemia, hypoproteinaemia and diabetes were not found to statistically influence the risk of formation of incisional hernia. Conclusion: The best abdominal closure technique should be fast and easy while preventing both early and late complications. Interrupted suturing technique for laparotomy midline closure was better than continuous suturing in this study because of the reduced incidence of incisional hernia. Keywords: Midline laparotomy, Continuous-in-three segments, Interrupted, Incisional Hernia.