Abstract: Objective To investigate the treatment of endometriosis by laparoscopic surgery, and to evaluate and analyze the therapeutic effect of laparoscopic surgery on endometriosis. Methods A total of 81 cases of endometriosis treated by laparoscopic surgery in our hospital from January 2015 to June 2018 were included as the observation group and 40 cases of endometriosis treated by open surgery in our hospital during the same period were the control group. Retrospective analysis was made to compare two groups in operative time, intraoperative blood loss, postoperative hospitalization days, incidence of adverse reactions, such as postoperative pain of differences. Patients in the two groups were treated with subcutaneous injection of leuprorelin acetate microspheres for 4-6 months after surgery, followed up for 36 months, and the recurrence rates of endometriosis in the two groups were compared, as well as the pregnancy rates of women under 40 years old in the two groups. Results The operative time (56.23±8.59) min, intraoperative blood loss (65.42±6.54) mL, and days of hospitalization (5.23±1.24) days in the observation group were significantly different from those in the control group (100.45±10.03) min, (105.63±8.26) mL, and (7.24±2.56) days (all P<0.05). After 36 months of follow-up, the recurrence rate of 3.70% (3/81) in the observation group was significantly lower than 25.00% (10/40) in the control group, and the pregnancy rate of 56.52% (35/62) in the observation group was significantly higher than 15.00% (3/20) in the control group (P<0.05). Conclusion In the surgical treatment of endometriosis, laparoscopic surgery has the advantages of short operation time, less blood loss, fewer days in hospital, low incidence of adverse reactions, low recurrence rate and high pregnancy rate, which can be considered as the preferred surgical treatment for endometriosis.