OBJECTIVE: The objective of this study was to determine the current practices of pediatric minimal access surgery (MAS) in our institute over a period of 3 years. BACKGROUND DATA: Pediatric MAS has received recognition among pediatric surgeons and is currently being practiced in most centers worldwide. However, studies in our region are limited. MATERIALS AND METHODS: This study was carried out in Sultan Qaboos university Hospital (Muscat, Oman). Medical records of all the children (0-12 years) who required abdominal, groin, or thoracic surgery between July 2009 and August 2012 were reviewed. Data analysis was carried out using SPSS v16. RESULTS: A total of 904 abdominal, groin, and thoracic procedures were performed in 790 children. In 257 (28.4%) procedures [emergency=164 (64%), elective=93 (36%)] minimal access was utilized. In total, 152 (60%) patients were males, whereas 102 (40%) were female. The age of the patients ranged from 0 to 12 years, with an average of 7.02±3.93 years (SD). Weight ranged from 2.8 to 61 kg [mean=23.74±12.16 (SD)]. The MAS modality included 251 (97.6%) laparoscopic and six (2.4%) thoracoscopic procedures. Conversion to open and complication rates were 3.5 and 5.05%, respectively. Follow-up period ranged from 3 to 40 months, with an average of 18.05±8.96 (SD). CONCLUSION: At Sultan Qaboos University Hospital, pediatric MAS is evolving as we are performing a number of diverse procedures at a comparable conversion and complication rate.