Aim <p>Laparoscopic upper moiety nephrectomy for a giant hydronephrosis in an infant is challenging. We demonstrate our approach in this operative video with emphasis on technique.</p> Materials and methods <p>A 1-year-old boy with antenatally detected left hydronephrosis was confirmed postnatally to have giant upper moiety hydronephrosis with hydroureter and poor function of the upper moiety. Laparoscopic upper moiety nephrectomy was planned. Transperitoneal approach was utilized with three 5&#xa0;mm ports with the primary port at the umbilicus. Key steps included medial reflection of colon, identification and careful preservation of lower moiety ureter, circumferential dissection of upper moiety ureter staying close to the ureteric wall, early distal division of the affected ureter and decompression of upper moiety, dissection of the divided ureter as high as possible followed by its transposition behind the vascular pedicle for traction, delineation of the upper moiety and division of the upper moiety vessels. The pliable infant abdominal wall and decompression of the upper moiety enabled creation of working space. Intravenous indocyanine green was used to further define the vasculature of the upper and lower moieties and aid separation from the lower moiety with careful dissection in the avascular plane within the renal sinus. Bladder was drained for 48&#xa0;h post-operatively.</p> Results <p>The procedure and recovery were uneventful. He was asymptomatic and the lower moiety was normal on follow-up ultrasound at 6&#xa0;months.</p> Conclusion <p>Laparoscopic approach is feasible and safe for upper moiety nephrectomy in giant hydronephrosis in infants.</p>