Purpose: Manual intussusception reduction can sometimes be accomplished through the existing umbilical incision after a laparoscopic attempt has failed. We compared the safety and efficacy of open transumbilical intussusception reduction (OTIR) and laparoscopic reduction (LAP). Methods: We prospectively enrolled children diagnosed with intussusception at our hospital from June 2014 to December 2018. Clinically stable patients who failed pneumatic intussusception reduction were randomly assigned to the 011R or LAP group. We compared reduction rates, complications, operative times, and surgery costs between the two groups. Results: Fifty-one of 451 patients with an intussusception met the study criteria. In the OTIR group (n = 27), 22 intussusceptions were successfully reduced, and 5 required incision extension. The mean operative time was 47.7 +/- 10.5 min, and mean surgery cost was 1259.74 +/- 46.24 US dollars. In the LAP group (n = 24), 5 patients required conversion to open surgery. Three of the 5 cases were resolved by OTIR, while the other 2 needed incision extension. The mean operative time was 68.63 +/- 17.13 min, and mean surgery cost was 1750.63 +/- 106.98 US dollars. Severe complications did not occur in either group. Conclusions: OTIR was as safe and effective as LAP and had a shorter operative time and lower surgery cost. OTIR is a good option for intussusception reduction in children. (C) 2020 Elsevier Inc. All rights reserved.