Background purpose: the authors have been using a preperitoneal approach for treatment of indirect inguinal hernia in 
children for the last 18 months. The aim of this paper is to report on this experience 
Methods: between December 2000 and may 2002 we used the preperitoneal approach through a transverse lower central abdominal crease incision for repair of 45 boys with indirect ingurnal hernias, 5 of them with clinically detectable bilateral hernia and 7 with incarcerated hernia, we explored the contralateral side in the same time. 
Results: Herniotomy, reduction of contents and dealing with it were found to be much easier than the inguinal approach. 
Complications were minimal. Exploration of the contralateral side was an added advantage. 
Conclusions: preperionteal approach appears to be a safe and easy technique for repair of inguinal hernia in children and for solving the dilemma of contralateral exploration. The authors recommend that it should be used more commonly.