Introduction: Minimal access surgery has evolved enormously and revolutionised surgical practice. With increasing use of Minimal access surgery, safety of methods of creating Pneumoperitoneum have come under intense scrutiny. Objectives: To observe the effectiveness and infra peritoneal events of using veress needle to create pneumoperitoneum in minimal access surgery. Study design: Prospective observational study. Period: From April to June 2004. Setting: Department of Surgery at Norfolk and Norwich University Hospital. Subject & Methods: 50 patients with male tofemale ratio 25:1 Veress Needle 14G was inserted infra umbilically through stab incision at angle of 45 degree. BMI (body mass index) and abdominal thickness was recorded. Intra peritoneal events of flow of msufflated air, intraperitoneal position of needle and ntraperitoneal adhesions were recorded. Results: (28/50) 56% of patients achieved free flow, (18/50) 36% patients achieved free flow with traction. 44% of patients had free veress needle tip and 44% had tip in omentum, 8% patients showed extra peritoneal air collection. All patients were fit enough to be discharged same day. Discussion: Our study has revealed that body mass index (BMI) and skin fold thickness does not effect the position of needle. With skin fold thickness increase free flow of air needs to be assisted by traction of abdominal wall. Conclusion: We conclude that Veress needle can be safely used for creating pneumoperitoneum in patients of any BMI and skin fold thickness.