Minimally invasive surgery (MIS) has become relatively commonplace in paediatric surgery, and is becoming more popular. Paediatric surgeons perform laparoscopic and thoracoscopic surgery with the commonly held belief that MIS is associated with a dampened stress response, more rapid postoperative recovery, and early discharge from hospital. There are also long-term cosmetic advantages. Depending on the operation in question, some of the potential advantages hold, but others do not, and we need to be conscious of potential disadvantages and difficulties when embarking on MIS.