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Introduction Sacrococcygeal teratoma is one of the commonest neonatal tumour usually presenting as a large exophytic sacral mass in utero and at birth. It is a highly vascular tumour and the main blood vessel supplying it is median sacral artery (MSA) which can cause torrential haemorrhage during excision. Many surgeons advocate ligation of MSA prior to tumour excision. Traditionally it was done by laparotomy or by posterior midline approach prior to tumour excision. Methods Laparoscopic ligation of MSA in neonates prior to tumour excision was performed using a ultrasonic dissector to expose the area. Using endoclips the artery was ligated, following which the tumors were resected. Results The procedures were completed with minimal blood loss and successul excision of the tumor was achieved in our patients. Conclusion Haemorrhage is the principal concern during sacrococcygeal teratoma excision. This risk can be safely minimized by laparoscopically ligating the median sacral artery which is the principal feeding vessel for the tumor.

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