Minilaparotomy, as described in this report, is surgical entry into the lower abdominal cavity through a small transverse suprapubic incision, for the purpose of tubal ligation. The 200 operations reported were performed under local anesthesia in a free-standing office surgical unit. For most women requesting sterilization, minilaparotomy is a highly satisfactory approach. For patients with fixed uterine retroversion, enlarged uteri, or suspected adnexal disease, open laparoscopy under local anesthesia is preferable. The standard Pomeroy technique was used in all cases. Analysis of a follow-up minilaparotomy questionnaire indicates a high degree of patient satisfaction. No subsequent pregnancies have been reported by these patients, but since no patient in this series has been followed for more than 2 years, no conclusion as to long-term failure rate may be made.