Laparoscopic surgery is widely accepted for nephrectomy in adult renal transplantation. The success of this technique has not been compared with open donor nephrectomy (ODN) in children. In this randomized clinical trial, a total of 40 adult kidney donors were randomly divided into two groups: Twenty cases of laparoscopic donor nephrectomy (LDN) and 20 of ODN. We included patients with age of <15 years. Our Exclusion criteria were: history of previous renal transplantation, hemolytic uremic syndrome, focal segmental glomerulosclerosis, oxalosis in recipients, and existence of multiple renal arteries in donors. All laparoscopic and open donor nephrectomies were completed as scheduled and no cases of LDN group required conversion to open nephrectomy. No patients in ODN or LDN groups required reoperation. Acute rejection was diagnosed in 6 cases of ODN (30%), and 4 patients (20%) in the LDN group (P=0.3). No recipients or donors in two groups died. One-year graft survival in the ODN and LDN groups were 310.8 ± 28.8, 302.7 ± 28.2 days, respectively (p=0.8). At our medical center, pediatric LDN recipients had graft outcomes comparable to those of ODN recipients. We recommend use of LDN for pediatric recipients at experienced centers.