Objective To describe the initial experience of transperitoneal laparoscopic renal plication for giant hydronephrosis,and to evaluate the clinical feasibility of the procedure. Methods This series included 12 cases of giant hydronephrosis (5 men and 7 women;age ranged from 19 to 64 years with a mean of 42.6 years).Of them 4 cases had upper ureter calculi;2 had ureteropelvic junction(UPJ) obstruction;2,middle ureter calculi;3,nephrolithiasis and 1,middle ureter stricture. The upper urinary tract obstruction was relieved and plication was performed via laparoscope. Results All the 12 operations were completed successfully.The intraoperative blood loss was 50 to 200 ml,operative time was 75 to 210 min.The postoperative follow-up lasted 3 to 18 months.In all these cases,hydronephrosis was relieved and renal function was improved. Conclusions Laparoscopic renal plication is an effective and minimally invasive method and can be considered as an alternative for treatment of giant hydronephrosis.