Purpose: A new endorectal pull-through technique using a transanal approach is presented in this report. Methods: Mucosectomy, colectomy, and pull-through are performed transanally, and neither laparotomy or laparoscopy are required. Five patients affected with Hirschsprung's disease have been operated on with this technique. Conclusion: During the 6- to 15-month follow-up period, all of them have had postoperative normal bowel movements. Copyright (C) 1998 by W.B. Saunders Company.