Until recently minimally invastive surgery was not performed in neonates. This was because of their small size and distinct physiological characteristics, neonates were not operated on using minimally invasive surgery until recently. Since the introduction of fine laparoscopic instruments, improvements in the surgical techniques and anaesthetic adjustments for laparoscopy, more complex operations are now being performed in neonates. While certain operations such as laparoscopic pyloromyotomy have become routine in many centres, some others require significant infrastructure and experience. Advantages of minimally invasive surgery seen in older children and adults, such as shortened hospital stay and less pain, also apply to neonates. There is no doubt that minimally invasive surgery for neonates is still in its infancy, and for many neonatal conditions requiring surgery, the benefits of minimally invasive surgery need to be established with well-designed studies.