The Working Group 'Surgrey in Children and Newborns', founded in 1974, was the precursor of the first subsection of the Association of Surgeons in the Netherlands, founded in 1981: the Netherlands Association for Paediatric Surgrey. Around 1900, paediatric surgery acquired an identity on the basis of what took place in children's hospitals. All the admissions were then on social indications with a surgeon being called in as a consultant if necessary. Following the Second World War, the development in anaesthesia and analgesia and an increasing understanding of metabolic processes made ever larger operations possible. The required specific expertise and the need to bring it together were decisive arguments for the foundation of the subsection. Since then, the developmental biological and genetic aspects of severe congenital malformations have, inter alia, become new topics for investigation; the consequences for medical ethics continue to be a point for attention.