Purpose: Was to compare one stage total transanal endorectal pullthrough and assisted transanal Soave (either by minilaparotomy or laparoscopy) for treatment of Hirschsprung's disease. Patients and methods: This study was conducted on 40 pediatric patients with Hirschsprung's disease. The patients were divided into two groups; group (A); 20 cases with one stage total transanal endorectal pullthrough, and group (B); 20 cases with assisted transanal Soave (10 cases mini-laparotomy (B1 ) and 10 cases laparoscopy (B2 )). Results: Mean age of patients was 20.01 months for group A and 17.14 months for group B. The ratio of male to female was 3:1 and P value was highly significant <0.001. The mean operative time in group A was 102 min. While in group B it was 117 min. The onset of oral feeding in group A was with mean of 1.7 ±0.86 days while in group B with mean of 2.25 ±0.97days. The mean postoperative hospital stay in group A was 4.2 ±1.73 days and in group B was 5 ±1.87days. Complications were more common in group B than group A, and more common in subgroup B1 than B2 . Conclusion: Transanal endorectal pull-through is characterized by a shorter operating time, less bleeding, shorter hospital stay, less morbidity and earlier recovery than similar open pull-through procedures.