Aim <p>In the last three decades, the field of surgery has evolved from open surgery to an era of minimal access surgery (MAS) which is conventionally 2 dimensional (2D). When the vision is 3 dimensional (3D), which is natural, the accuracy and safety of procedures can be improved and complex reconstructive MAS procedures can be performed with depth perception. The aim was to assess feasibility, safety and efficacy of 3D MAS in the paediatric age group.</p> Methods and material <p>Retrospective analysis of 209 3D MAS procedures in the department of Paediatric Surgery over a period of five years. Subjective rating of image quality and difficulty score was done immediately after each procedure by operating and assistant surgeons. Likert scale was used. All data recorded was analysed and are represented as mean, median or percentage.</p> Results <p>The average score for subjective rating of image quality was 9.71 for surgeon and 9.74 for assistant surgeon with some parameters having higher subjective scores for the procedures on infants. It explains advantage of 3 D vision in every aspect of imaging. Mean difficulty scores for surgeon (0.12) and assistant surgeon (0.10) were very low, suggesting encouraging vision for the surgeons.</p> Conclusions <p>The use of 3D in paediatric minimal access surgery is feasible and safe. Advantage of excellent vision with depth perception is unequivocal, which along with the use of conventional hand instruments can be a good alternative to more expensive robotic surgical systems.</p>