Purpose: The present study was conducted to examine cosmetic results and patient satisfaction with their umbilical scar after vertical versus subumbilical incision for abdominal laparoscopy in children and adolescents performed between 2010 and 2015 at the Medical University of Vienna. Methods: 38 patients completed the Patient Scar Assessment Questionnaire measuring patient satisfaction with their umbilical scars. Cosmetic results of 27 of these patients were evaluated during a follow-up visit using the Observer Scar Assessment Scale. Results: There were 63% female and 37% male participants in the study, with age ranging from 2 to 22 years. The participants in the vertical-incision group (15 participants) were on average younger and mostly male, whereas participants in the subumbilical-incision group were older and mostly female. The vertical incision showed better results than the subumbilical incision in three out of four sections of the patients questionnaire, namely 'Appearance', 'Consciousness' and 'Satisfaction with Appearance', as well as in observer evaluation. A t-test showed significantly better results for the vertical incision in one out of four sections of the patient questionnaire, namely 'Satisfaction with Appearance'. Conclusions: The results of this study favour the vertical incision, with the difference between the incision groups stronger than in some of the comparable studies found in the literature. However, this may be at least partly due to demographic differences between the two incision groups regarding sex, age, and time since operation.