Abstract: Objective To analyze and explore the clinical effect of hysteroscopic lesion electrotomy combined with levonorgestrel releasing intrauterine system(LNG-IUS) treatment of early endometrial cancer(EC) and endometrial atypical hyperplasia(EAH). Methods A total of 34 patients with early EC and EAH admitted to our hospital from January 2017 to March 2018 were collected, They were divided into two groups according to different treatment schemes, 17 cases in each group. The control group was treated with diagnostic curettage combined with high dose progesterone, while the observation group was treated with hysteroscopic lesion electrotomy combined with LNG-IUS. Therapeutic effects, adverse reactions and complications of two groups were observed. The serum carbohydrate antigen 125(CA125) and human epididymis protein 4(HE4) levels were detected and compared. SPSS 20.0 statistical software was used for analysis. Results The complete remission rate was 82.35%(14/17) in the observation group and the total effective rate was 100.00%(17/17), which was higher than 70.59%(12/17) and 94.12%(16/17) in the control group, but there was no significant difference between the two groups(P>0.05). The incidence of adverse drug reactions in the observation group was significantly lower than that in the control groups(P<0.05). There were 3 cases of secondary intrauterine adhesions in the control group, and there was no statistical difference between the two groups. There was no significant difference in CA125 and HE4 levels between the two groups at the same time point before and after treatment(all P>0.05). The levels of CA125 and HE4 in the two groups at 6 and 12 months after treatment were significantly lower than those before operation(all P<0.05). Conclusion Hysteroscopic lesion electrotomy combined with LNG-IUS in the treatment of early EC and EAH has definite clinical effect, less adverse drug reactions and complications of uterine cavity operation, which is expected to become the routine treatment of early EC and EAH with fertility-sparing treatment, thus is worthy of clinical promotion.