AIMS: Management options in pediatric pheochromocytoma may be open or laparoscopic surgery but the surgical difficulty increases with increase in size especially in pediatric age group. We compared the laparoscopic management of unilateral & bilateral pheochromocytomas with size =4cm. Methods: A retrospective review was performed of laparoscopic adrenalectomies for pheochromocytoma by 2 surgeons over a 3-year period. All patients underwent lateral transperitoneal surgeries. Operative & outcome data were retrieved & compared for tumours >4 cm versus smaller tumours. Results: We performed 11 laparoscopic adrenalectomies on 8 patients including 2 simultaneous bilateral surgeries. Five tumors were >4 cm in size (mean 5.7 cm) while 8 were smaller (mean 3.3 cm). Conversion from lap to open was required for only 2 adrenalectomies (18%), where size of both were >4cm & incidentally both were bilateral as well. Rest all were operated laparoscopically . Only one patient (12%) is on anti-hypertensive medication post-operatively . Conclusion: Laparoscopic adrenalectomy is feasible & safe in pediatric pheochromocytoma cases, however with tumor size >4cm the chances of conversion to open increases.