The Ramstedt pyloromyotomy is the procedure of choice for infantile hypertrophic pyloric stenosis. Although most surgeons use a right upper quadrant or midline incision, Bianchi and Tam described an approach through the umbilical fold which is cosmetically superior. Despite published data from our group demonstrating no increase in operative or postoperative complications, the umbilical fold incision has not been widely adopted. This video demonstrates pyloromyotomy using the umbilical fold incision, highlighting the excellent exposure to the pylorus and the superior cosmetic results. This technique should be considered by all surgeons operating on infants with hypertrophic pyloric stenosis.