This videotape demonstrates resection of a huge exophytic sacrococcygeal teratoma in a one-day-old female. At the time of admission to the hospital, there was already severe ulceration of the covering of the tumor. The tape shows the detailed outlining of the skin incision, which is critical for proper placement of the anal opening following resection of the tumor. Reconstitution of the levator muscular sling and the gluteal muscles on each side is shown in the videotape, following removal of the tumor.