Since birthday, A 3th - month-old fullterm male was admitted frequent post prandial non bilous emesis. Physic examination and ultrasonography didn ât found sign dan symptoms of Hypertrophy Pyloric Stenosis (HPS. At the Upper Gastrointestinal (UGI) examination of radiology by kontrast we found shoulder sign, tit sign, beak sign, string sign, umbrella sign, double road trail sign that performed Hipertrophy Piloric stenosis (HPS). The treatment of HPS ispyloromyotomy with Fredet-Ramstedtpyloromyotomy metode, wich splits the muscle longitudinally. Patients generally remain hospitalized until post operative re-feeding is established. The conclussion of the case if as clinically and physic examination don ât clear to diagnose HPS, upper gastrointestinal by contrast can be used to indicated of piloromyotomi.Telah dilaporkan kasus bayi laki-laki, usia 3 bulan dengan keluhan regurgitasi setiap minum ASI. Hasil pemeriksaan fisik tidak menunjukkan adanya kelainan demikian pula hasil pemeriksaan Ultrasonografi. Sesuai protokol untuk penegakan dignosis dilakukan pemeriksaan radiologi Upper Gastrointestinal (UGI) dengan kontras barium encer. Hasil pemeriksaan UGI mengarah ke Hipertrofi Pilorus Stenosis (HPS), yaitu didapatkan gambaran shoulder sign, tit sign, beak sign, string sign, umbrella sign, double road trail sign. Atas dasar hasil pemeriksaan UGI dilakukan operasi dengan metode Fredet-Ramstedt pyloromyotomi yang hasilnya positif adanya penyempitan dan penebalan pilorus. Kesimpulan: Pada kasus HPS bila hasil pemeriksaan klinis meragukan, pemeriksaan UGI mempunyai peran penting dalam menetapkan indikasi piloromyotomi.