By default, using #[] will retrieve the hash value if it exists, and return nil if it doesn't exist *.
Using #fetch gives you a few options (see the docs on #fetch):
fetch(key_name): get the value if the key exists, raise a KeyError if it doesn't
fetch(key_name, default_value): get the value if the key exists, return default_value otherwise
fetch(key_name) { |key| "default" }: get the value if the key exists, otherwise run the supplied block and return the value.
Each one should be used as the situation requires, but #fetch is very feature-rich and can handle many cases depending on how it's used. For that reason I tend to prefer it over accessing keys with #[].
* As Marc-André Lafortune said, accessing a key with #[] will call #default_proc if it exists, or else return #default, which defaults to nil. See the doc entry for ::new for more information.