The use of minimally invasive surgery (MIS) for the diagnosis and treatment of neurogenic tumours has markedly increased over the past decade, evolving from a diagnostic and staging tool to a therapeutic option in carefully selected cases. The advantages of MIS—reduced postoperative pain, shorter hospital stay, and faster recovery—must be weighed against its technical challenges, including limited operative space, loss of tactile feedback and increased risk when image-defined risk factors are present. This chapter reviews current evidence, outlines practical indications and contraindications and proposes structured guidelines for MIS in paediatric neurogenic tumours to assist surgeons in safe adoption while maintaining oncologic integrity.