Further to previous findings in adults, increased adoption of minimally invasive techniques for nephrectomy has now also been demonstrated in children. New analysis of the Nationwide Inpatient Sample demonstrates that a total of 27,615 children underwent nephrectomy in the USA between 1998 and 2010, and although the annual nephrectomy rate remained stable during this time, the use of minimally invasive techniques increased from 1.1% to 11.6%. Children with benign pathology were more likely to undergo minimally invasive nephrectomy than those with cancer.