Introduction: The pyloric muscle is a sphincter defining the transition between the stomach and duodenum ,it control the outflow from the stomach preventing passage o f large pieces o f food to the duodenum , and to prevent backflow o f intestinal content to the stomach. Infantile hypertrophic pyloric stenosis IHPS is familiar to most pediatric and general practitioners. There is hypertrophy and hyperplasia o f the antropyloric portion o f the stomach, which becomes abnormally thickened, it m anifests as obstruction to gastric emptyingnbsp;Purpose and Objectives: Highlighting the etiology, clinical manifestation, diagnosis and surgical treatment in hypertrophic pyloric stenosis behalf o f the literature and case report, comparing open versus laparoscopic procedure. Materials and methods: The project is based on 20 articles and 5 published case report regarding hypertrophic pyloric stenosis, one patient case study. Results: the etiological factor for infantile hypertrophic pyloric stenosis rem ain idiopathic, with new risk factor erythromycin that will bind to motilin receptors directly on sm ooth muscle and cause contraction o f pyloric bulb in addition to other risk factor like maternal sm oking, and bottle feed. Infants with IHPS are clinically normal at birth, but they develop a nonbilious forceful vomiting during the first weeks o f postnatal life, which is described as quot;projectilequot;, if the child remain without treatment it will cause dehydration symptoms. The clinical diagnosis hinges on palpation o f the thickened pylorus quot;straightforward after palpation o f the olive sign in lateral rectus abdomens muscle after feeding the childquot; and the best alternative method is ultrasound o f abdomen due to little cost and effectiveness. The treatment is surgical with two main m ethod open pyloromyotomy ramstedt procedure or laparoscopic pyloromyotomy procedure. Conclusion: The laparoscopic pyloromyotomy is more effective with less com plication and faster time recovery with minimal scar tissue, the progressive is excellent norm ally without complication.