Successful Management of Infantile Hypertrophic Pyloric Stenosis A 3-month-old female infant presented with approximately 20 days of persistent projectile, non-bilious vomiting, poor feeding, progressive dehydration, and lethargy despite medical treatment. The diagnosis of Infantile Hypertrophic Pyloric Stenosis (IHPS) was confirmed by abdominal ultrasound. The infant was initially stabilized with IV fluid resuscitation, correction of dehydration and electrolyte/acid–base abnormalities, and nasogastric decompression. Following successful pre-operative optimization, Ramstedt pyloromyotomy was performed. The hypertrophied pyloric muscle was carefully split while preserving the mucosa, with excellent gastric outlet decompression. Post-operatively, the baby was monitored in the ICU, received appropriate fluids and pain management, and oral feeds were successfully initiated after 12 hours. Feeding was well tolerated with no post-operative complications, and the baby was discharged on postoperative day 2 in stable condition. Key message: Early recognition, appropriate metabolic correction, and timely pyloromyotomy provide excellent outcomes in infants with IHPS.