BACKGROUND In recent years surgical procedures have developed enormously outpacing the rapid growth in medicine. OBJECTIVE The aim of this article is to highlight the trends in surgical treatment over the past decade in comparison with reports in the scientific literature. METHODS We reviewed the surgical trends in the Pediatric Surgical Department at the Sheba Medical Center between the years 1995-2006. The main parameters implemented in the assessment were: laparoscopic approach vs. traditional open surgery, elective vs. emergency operations and the extent of congenital abnormalities treated over the years. RESULTS This study showed a decline in the number of open surgeries performed as opposed to a statistically significant increase in laparoscopic procedures and a decrease in elective surgery performed in tertiary medical centers, while the number of congenital abnormalities treated remained constant. CONCLUSIONS The literature review revealed that similar changes in surgical management were found in other countries, confirming our study results. These trends, including clinical, professional and fiscal developments, require preparedness on a national level.