Laparoscopic pyloromyotomy has obtained increasing importance in the last years. However, there is no proof of an obvious advantage of the laparoscopic over the open approach. This retrospective analysis of 157 infants with pyloromyotomies (129 open and 28 laparoscopic procedures) should settle the benefit of one of these procedures. The duration of the operation in the laparoscopic procedure was significantly shorter than in open pyloromyotomy (median 25 versus 34 min; p = 0.025). Complete oral feeding was reached after similar postoperative time in both groups, but the postoperative hospital length of stay in the laparoscopic group was significantly shorter than in the open group (3.5 versus 7 days, p = 0.008). The postoperative requirements for analgetics were low and showed no difference in both groups. In our clinic the laparoscopic pyloromyotomy was successfully introduced as standard operating procedure. There was no difference in the complication rate as compared to the open procedure. The recovery time was shorter in the laparoscopic group. A superiority of the laparoscopic pyloromyotomy over the open procedure is suggested by the ascertained data.