The ability to perform laparoscopic procedures in children is due to the remarkable advances in endoscopic technology and laparoscopic equipment. Although laparoscopy was first reported in 1901, poor exposure and inadequate visualization hampered advances in this area until fiberoptic technology was developed in the 1960s. Recently, the improved endoscope was combined with a xenon light source and computer chip camera to provide the visual images necessary for laparoscopic surgery. This article discusses the operative technique for creation of the pneumoperitoneum and the equipment necessary for the procedures, and reviews the complications from diagnostic laparoscopy. Further advances in technology surely will allow more procedures to be performed endoscopically.