Background: Necrotizing enterocolitis (NEC) is an acute condition in neonates and continues to be a primary etiology of neonatal morbidity and mortality. Aim: To evaluate the efficacy of exploratory laparoscopy in necrotizing enterocolitis on mid-term follow-up. Patients and methods: This were a prospective trial. conducted between April 2022 and October 2024. The study included 50 children who underwent surgical intervention for NEC, consisting of pediatric surgery combined with exploratory laparoscopy. The cases have been divided into two groups based on their weight: Group A (35) (weight < 1000 g) and Group B (15) (weight ≥ 1000 g). Results: The mean weight of the investigated cases was 1225.26 ± 44.8; 48% of cases were males, and 52% were females. Mean saturation during surgery was 93.8 ± 0.6, mean systolic pressure during surgery was 59.7 ± 2.3, and mean diastolic pressure during surgery was 34.8 ± 1.8. A statistically insignificant distinction has been observed among the investigated groups as regards Bell stages. A statistically insignificant distinction has been observed among the investigated groups as regards surgical procedure. A statistically insignificant distinction has been observed among the investigated groups as regards outcome. Conclusion: Regarding our results, it is concluded that a statistically insignificant distinction has been observed among the investigated groups as regards Bell-Stages, surgical procedure, and regarding outcome.