Testicular autotransplantation is an advanced technique for the correction of high intra-abdominal testicles with inadequate vascular length for repositioning in the scrotum. In the past, surgeons have often avoided this approach due to the extended operative time and the requirement for microsurgical equipment and training. Surprisingly, this procedure remains rare despite the fact that autotransplantation is sometimes the most viable option to relocate the testicle. Further, current advances in laparoscopic surgery allow for testicular harvesting with minimal morbidity and maximal vascular pedicle length. Here, the evolution and an approach combining these two techniques implemented successfully in five patients are presented.