Objective:  To review our initial experience with prescrotal orchipexy, to illustrate this surgical approach, and to compare it with the standard two incision inguinal approach. Material and Methods: This is a single institution retrospective comparative review of 135 patients (pts) who underwent orchiopexy for UDT over 4 years. Pts undergoing the standard inguinal orchiopexy were compared to those undergoing the emerging single-incision prescrotal approach in regards to operative time, complications and cosmesis. Results: The study was completed on 96 pts who met the inclusion criteria. Group A (72 pts, 75%) underwent the standard two-incision inguinal orchiopexy while Group B (24 pts, 25%) underwent the single-incision prescrotal orchiopexy. Average age at surgery was 3.2 years, with a mean follow up of 13 months. Average operative time was 56 minutes for Group A and 32 minutes for Group B, by using SPSS significant P value difference (p < 0.05) was calculated . All patients from the two groups had uneventful postoperative period with one pt in Group A who had a scrotal wound infection. None of the pts in Group B need conversion to the inguinal approach. At last follow-up, all patients in both groups had testicles in the scrotum with no atrophy. While the cosmetic appearance in Group A was acceptable, cosmesis in Group B was superior. Conclusion: Prescrotal orchipexy is a safe alternative to the standard inguinal orchiopexy for the palpable UDT. Our study demonstrates similar outcome, shorter operative time and superior cosmesis.