BACKGROUND: Laparoscopy requires a unique subset of surgical skills that, for the inexperienced, can significantly delay the development of basic operative skills. We hypothesized that learning laparoscopic suturing and knot tying would improve leparoscopic skills. METHODS: A laparoscopic training seminar for junior surgical residents was established to test this hypothesis. Emphasis was placed on laparoscopic knot tying and suturing. Skills were assessed at the beginning and the end of the course. RESULTS: All residents showed significant improvement. Dominant and nondominant hand skills improved by 30.2% end 26.9%, respectively. Two-handed skills improved by 58.6% and 30.1%. Overall scores improved by 28.9%. CONCLUSIONS: A structured laparoscopic skills course stressing knot tying and suturing is an effective way to develop dexterity end significantly improve the performance of laparoscopic tasks. These improvements can be accomplished in a cost- effective curriculum that should enhance the surgical education of residents and speed the acquisition of competent operative skills.