Objective To evaluate the clinical effect of laparoscope and open surgery for treatment of gynecological diseases. Methods 620 female patients with gynecological diseases were divided into two groups randomly (Group A: n = 310, Group B: n = 310). Group A was treated by laparoscopic surgery, Group B was treated by open abdominal surgery. The clinical effects of laparoscope and open abdominal surgery were compared between the two groups. Results Group A had better results in intraoperative blood loss, recovery time of intestine and stomach function, get out of bed time and hospitalization time than that in group B, there were significant difference (P < 0.01). The gastrointestinal reaction rate after operation, the anodyne utilization, the complication incidence rate was 9.7 %, 5.2 %, 3.9 % respectively, it is lower than that in group B; and wound healing was better in group A than group B, with statistical difference (P < 0.01). There was no significant difference in operation time between the two groups (P > 0.05). Conclusions Laparoscopic surgery has better effects for treatment of gynecological diseases than open abdominal surgery.