Iliohypogastric/ilioinguinal block is one of the peripheral nerve block techniques used in inguinal and lower abdominal surgery. Orchidopexy is a surgery that is often performed on pediatrics patients. Aim: This paper aims to present a case study on the utilization of ultrasound-guided iliohypogastric/ilioinguinal blocks in patients with Down syndrome who are undergoing orchidopexy surgery. Case Presentation: A 4 year old, 11 kg boy, was diagnosed with undescended left testis and retracted right testis. The patient underwent bilateral orchidopexy. The surgery was performed with general anesthesia, using intubation for airway management, sevoflurane for sedation maintenance, and iliohypogastric block using local anesthetic 4ml of 0.2% ropivacaine for right iliohypogastric and 3ml of 0.25% levobupivacaine for left iliohypogastric with ultrasound guidance. Conclusion: The use of a combination of general anesthesia with iliohypogastric block in orchidopexy surgery can lower the dosage of opioid, postoperative pain and the incidence of postoperative nausea and vomiting. The use of ultrasound on this block can improve the accuracy.