The purpose of this study is to determine the role of surgical intervention in pre-menarchal patients with recurrent abdominal pain. Seventy-six pre-menarchal females aged 9-12 were examined for recurrent abdominal pain; during clinical observation blood tests were within normal values and abdominal and pelvic US showed no surgical or gynaecological problems. After laparoscopic appendectomy the patients' clinical-surgical findings were related to their age, relief of symptoms and histopathological findings. A total of 71% of patients showed positive surgical findings; 55.5% of these showed variations in the position of the appendix with mild inflammation and reactive pericaecal lymph nodes, 7.5% had a macroscopic inflammation with adhesions and 37% had a mild inflammation. Twenty-nine percent of patients had a normal appendix without adhesions, inflammations or infections. Histopathological examination showed a pathologic appendix in 60 cases (79%). Six months after surgery abdominal pain persisted in 18 patients out of 76 (23%). There is a statistically significant relationship between recurrent abdominal pain, surgical observation and relief of symptoms (P < 0.05). We believe that patients affected by recurrent abdominal pain need to be closely and simultaneously monitored. For this reason, laparoscopy should be considered and used with those patients suffering from frequent abdominal pain and discomfort.