Laparoscopic nephrectomy has become the technique of choice for live donor nephrectomy. However, limited data are available regarding the role of this technique for pediatric recipients whose parents need additional information. Since March 2003, we have performed laparoscopic nephrectomy in more than 400 consecutive patients for live donor transplantation. Of these, 39 cases were identified that involved a recipient younger than 17 years of age. The preoperative, intraoperative, and postoperative data were reviewed to analyze the outcome of these cases. We used the left kidney in 26 cases and the right kidney in 13 cases. Seven cases had double renal arteries and these were reconstructed on the bench table in the form of side to side anastomosis. The mean donor and recipient age was 31 years (range 22-34) and 13 years (range 6 to 17), respectively. The mean donor operative time was 2.1 hours (range 1.2 to 3.2). The warm ischemia time averaged 3 minutes (range 2 to 5). In 27 cases we used the common iliac artery and common iliac vein for vascular anastomosis. In 12 cases the anastomosis was performed to the aorta and vena cava. Seven patients had prior augmentation cystoplasty and the ureter was anastomosed to the pouch directly. All the grafts functioned immediately, with a mean creatinine at 24 hours of 1.5 mg/dL (range 0.3 to 4.0). At last follow-up (mean 13.6 months), the mean creatinine was 0.9 mg/dL. One patient lost the graft due to severe rejection that was resistant to ATG. Our early experience with laparoscopic donor nephrectomy for pediatric recipients confirmed that the technique provides quality organs with excellent function. The method yields outcome comparable to those after traditional open donor nephrectomy and does not require modifications for the recipient operation.