Aims of the work: - To study the epidemiological, clinical and therapeutic features of our patients operated for SHP.- To compare the sub-costal approach and the umbilical approach.- To propose a protocol for the management of HPS.Methods: We performed a retrospective study of 90 infants operated for hypertrophic pyloric stenosis, at the pediatric surgery department of Sfax, during the period from January 1, 2013 to October 31, 2017.Results: We found a mean age at admission of 39.3 days with a sex ratio of 3.7. Typical food vomiting was noted in 85.6% of. Clinical examination showed a palpable pyloric olive in 23.3%, hypotrophy in 72.2%, and ultrasound confirmed the diagnosis in 96.6% of cases. The surgical approach was subcutaneous in 25.6% and umbilical in 74.4%. The comparative study showed that the operating time by sub-costal incision was shorter than that by umbilical incision.Conclusion: Hypertrophic pyloric stenosis is a benign condition. It must remain so by an early and adapted diagnostic and therapeutic management