Over a two-year period, 54 laparoscopic explorations for acute abdominal pain in children have been performed. In two cases primary torsion of the greater omentum was the underlying cause. Both patients (one boy of 13 years of age, one girl aged 8 years) were obese. The clinical picture mimicked acute appendicitis, but laparoscopic exploration showed torsion of the greater omentum which was then excised. The authors believe that primary omental torsion was underestimated, because many cases were not recognised, even during laparotomy for appendicitis. Laparoscopy permits accurate diagnosis of this disease.