The midline preperitoneal approach has been used to facilitate delivery of 42 high undescended testicles into a suitable scrotal position. The gonads were situated preoperatively either within the abdomen (59.5%) or in a high inguinal position (40.5%). The technique described here has allowed marked lengthening of the spermatic cord and visibly shortened the distance between the spermatic vessel-great vessel juncture and the most dependent portion of the scrotum. It has virtually eliminated the necessity for staged orchiopexy in patients with heretofore difficult to manage cryptorchism. In this series an overall satisfactory anatomic result was achieved in 76.9 per cent of patients.