Endoscopic surgery has been established in various surgical conditions in children and infants for the past 10 years after pioneering work by experts specializing in pediatric endosurgery. These include pull-through for Hirschsprung's disease and anorectal malformations, pyloromyotomy, hernia repair, and endoscopic surgery for malignancies, malrotation, intussusception, etc. Laparoscopic pull-through is now accepted as a standard modality for the treatment of Hirschsprung's disease. Advanced endoscopic procedures such as esophageal atresia repair or fetal tracheal occlusion have also been performed. An efficient system for training is needed to compensate for the small number of patients and varieties of specific illness in children.