Fascetti-Leon F et al. Neonatal Bilateral Spigelian Hernia Associated ... Eur J Pediatr Surg 2010; 20: 123 – 125 Introduction & Spigelian hernia (SH) is a very rare entity in children and infants. A recent report found only 30 pediatric patients described in the English literature  . In males (the M:F ratio is 2:1), the association rate with cryptorchidism is 80 % . The site of the defect in the lateral abdominal wall is well defi ned: the intersection between the semilunar and the lateral edge of the rectus abdominis muscle is always the weakness point of the abdominal wall in these patients. A cause-and-eff ect relation between cryptorchidism and the abdominal defect has been suggested; however the pathogenic pathway is still far from clear. To contribute to the knowledge of this entity and its possible malformative associations we present a patient from our Department in whom bilateral Spigelian hernias were found at birth. In addition to bilateral cryptorchidism, the newborn had aplasia cutis congenita (ACC) of the scalp: this malformation is a rare entity, localized in the scalp in around 75 % of cases  , and previously described in association with other abdominal wall defects  .