With a continued movement toward minimally invasive surgical interventions, the range of applications treated with laparoscopic surgery will continue to grow. Laparoscopy is a preferred method for various reasons, including decreased postoperative pain, shorter inpatient hospital stays, and decreased convalescence. Ureteropelvic junction obstruction (UPJO) has traditionally been treated by open pyeloplasty. In patients with horseshoe kidneys, the blood supply is aberrant, which adds complexity to the procedure. We present the second reported case of a pediatric patient with a horseshoe kidney found to have UPJO who was successfully treated with transperitoneal laparoscopic pyeloplasty.