A single-incision pediatric endosurgery (SIPES) has not been typically used for operations in premature infants yet. We report a case of a 3-month-old 25-week premature infant who underwent SIPES-assisted ileocecal resection for a stricture after medically treated necrotizing enterocolitis. The patient recovered uneventfully, and was discharged on full feeds 15 postoperatively with virtually no appreciable scar. SIPES is a reasonable alternative for NEC stricture resection in premature infants. Prematurity should not be considered a contraindication to single-incision endosurgery.