Objective To investigate the efficacy of single-port laparoscopic versus multi-port laparoscopic lesion removal in patients with adenomyosis(AM).Methods Eighty patients with AM who were treated at Nanyang First People's Hospital from March 2020 to March 2023 were selected as the research subjects and divided into single-port group(n=40)and multi-port group(n=40).The patients in the single-port group underwent single-port laparoscopic lesion resection,and the patients in the multi-port group received multi-port laparoscopic lesion resection.The uterine volume,lesion area,pain degree,menstrual blood volume,levels of carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153)and sex hormone indexes[anti-Müllerian hormone(AMH)and estradiol(E2)],and clinical efficacy of treatment were compared in the two groups.Results There was no statistically significant difference in the uterine volume and lesion area of patients between the two groups before treatment(P＞0.05).The uterine volume and lesion area of the patients in the two groups after treatment were lower than those before treatment(P＜0.05);the uterine volume and lesion area of patients in the multi-port group were significantly lower than those in the single-port group after treatment(P＜0.05).The visual analogue scale(VAS)scores and pictorial blood loss assessment chart(PBAC)scores of patients in the two groups before treatment had no significant difference(P＞0.05).The VAS and PBAC scores of patients in the two groups after treatment were significantly lower than those before treatment(P＜0.05);the VAS scores of patients in the multi-port group were significantly higher than those in the single-port group after treatment(P＜0.05),and the PBAC scores in the multi-port group were significantly lower than those in the single-port group(P＜0.05).There was no statistically significant difference in the serum CA125 and CA153 levels between the two groups before treatment(P＞0.05).The serum CA125 and CA153 levels of patients in the two groups after treatment were significantly lower than those before treatment(P＜0.05),and the CA125 and CA153 levels of patients in the multi-port group were significantly lower than those in the single-port group after treatment(P＜0.05).There was no statistically significant difference in AMH and E2 levels between the two groups before treatment(P＞0.05).After surgery,the AMH levels of patients in the two groups were significantly higher than those before surgery(P＜0.05),and the E2 levels were significantly lower than those before surgery(P＜0.05);the AMH levels of patients in the multi-port group were significantly higher than those in the single-port group(P＜0.05),and the E2 levels were significantly lower than those in the single-port group(P＜0.05).The overall effective rate of patients in the multi-port group and the single-port group was 85.00％(34/40)and 62.50％(25/40),respectively after surgery;the overall effective rate of patients in the multi-port group was significantly higher than that in the single-port group(x2=5.230,P＜0.05).Conclusion Compared with single-port laparoscopic lesion excision,multi-port laparoscopic lesion excision for AM can effectively reduce uterine volume and lesion area and improve menstrual blood volume,CA125 and CA153 levels,and sex hormone level with superior efficacy;however,due to the number of surgical incisions,the degree of pain of patients after the operation is more serious.