Objective To summarize the causes for conversion and reoperation of laparoscopic Ladd's procedure in children with intestinal malrotation, so as to explore the countermeasures. Methods The clinical data and surgical videos of 107 children with intestinal malrotation, who underwent laparoscopic Ladd's procedure from Jan. 2014 to Jan. 2017 in our hospital, were retrospectively analyzed. The intraoperative findings, postoperative complications and reoperation were analyzed. Results There were 88 males and 19 females, with the ratio of male to female being 4.6:1, and the median age was 28 d (1 d to 14 years), with 55 neonates (≤ 28 d) and 52 non-neonates (>28 d). Laparoscopic Ladd's procedure was successfully performed in 99 cases. All the eight cases converted to open surgery were neonates. Among them, four cases were difficult to judge the rotation direction, one case complicated with annular pancreas, one case with duodenal septum, one case with blurred visual field, and one case with mesenteric vascular injury. A total of 15 cases underwent reoperation. One 8-year old patient underwent laparoscopic exploration 2 weeks after laparoscopic Ladd's procedure due to intestinal obstruction, and duodenal ulcer perforation was confirmed during the operation; the remaining 14 cases were all neonates. During the reoperation of the 14 neonates, nine cases were confirmed as incomplete lysis of the initial end of duodenum jejunum, two cases were caused by intestinal adhesion, one case by duodenal diaphragm, one case by colonic stenosis, and one case by intestinal perforation due to intestinal obstruction closure of the incision. Conclusion Laparoscopic Ladd's procedure is safe and feasible in the treatment of intestinal malrotation, but there are still some difficulties in neonatal patients. It is helpful to improve the success rate of laparoscopic Ladd's procedure by improving the preoperative examination, strictly controlling the operation indications, adopting different surgical strategies and skilled laparoscopic techniques.