〔Abstract〕 Objective To study the effects of laparoscopic total hysterectomy and myomectomy on patients with uterine fibroids. Methods 114 patients with uterine fibroids who underwent surgical treatment in Shangrao Fifth People's Hospital from February 2017 to October 2020 were selected as the research objects, and the patients were randomly divided into control group (57 cases, laparoscopic total hysterectomy) and observation group (57 cases, laparoscopic myomectomy). Clinical efficacy, ovarian function [including estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH)] and incidence of complications were compared between the two groups. Results The total clinical effective rate of the observation group was 96.49%, which was significantly higher than 85.96% of the control group, the difference was statistically significant (P < 0.05). The amount of intraoperative blood loss, operation time, postoperative gastrointestinal function recovery time and hospital stay in the observation group were less than those in the control group (P < 0.05). After surgery, E2 levels in the two groups were lower than that before treatment, and the E2 level in the control group was lower than that in the observation group, while FSH and LH levels were higher than those before treatment, and FSH and LH levels in the control group was higher than those in the observation group (P < 0.05). The incidence of complications in the observation group was 5.26%, which was significantly lower than 17.54% in the control group (P < 0.05). Conclusion Myomectomy has a more significant clinical effect in the treatment of uterine fibroids, which can preserve the ovarian function of patients with relatively little influence on ovarian function, and can effectively promote the postoperative recovery of patients, and has a certain degree of safety.