We describe our initial experience with retroperitoneoscopic procedures in children in the prone position. Twelve children (five girls and seven boys; mean age 3.5 years) underwent nephrectomy, nephroureterectomy or heminephroureterectomy for obstruction or reflux within the non-functioning kidney, multicystic dysplastic kidney or upper pole dysplastic moiety. None of the operations were converted to an open procedure. The mean operative time for these procedures was 110 minutes. Blood loss was less than 20 ml.