Circumcisions are among the most frequently performed operations in children and numerous techniques are employed often with varying results. Use of the Plastibell (Hollister Incorporated, Illinois, USA), under local anesthetic, is popular for cultural and religious circumcisions but is not without its problems. Complications of Plastibell (slippage, migration, bleeding and serious infection) have been reported. Described is a prospective series of cases in which modifications to the standard Plastibell technique were utilized to improve outcomes, in particular, the risk of bleeding.