Abstract Introduction: Femoral hernia (FH) is extremely rare in children, comprising 0.1%–0.9% of all inguinal region hernia repairs, as reported in the prelaparoscopic era.1,2 In centers where inguinal hernia (IH) is treated laparoscopically, FH was diagnosed in 1.1%–2.8%,1,2 suggesting a higher actual prevalence. Many cases are diagnosed perioperatively or discovered only when an IH recurrence occurs.3 We propose a laparoscopic approach to close the femoral ring, according to McVay's principles.4 Materials and Methods: A 4-year-old boy was referred to our service for IH. His parents and the pediatrician observed a recurring bulging in the right inguinal region. On examination, the bulging appeared below and laterally to the pubic tubercle while the boy was straining, but quickly reduced spontaneously. The child was scheduled for a laparoscopic reparative operation of a FH. A 5-mm 30° scope placed in the umbilicus, two 3.5-mm trocars placed in both flanks, and CO2 insufflation at 8 mm Hg were used. On in...