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Three cases of Nd:YAG laser bowel injury occurring at the time of endometrial ablation are reported. The first incident was due to energy transmission through extremely thin myometrium. Probable fiber perforation of normal myometrium resulted in bowel injury of the second patient. The third case involved heat transmission through a normal myometrium while operating at higher than usual laser power. As the number of Nd:YAG ablations continues to increase, more complications will occur. Steps to ensure its safe application are reviewed. (J GYNECOL SURG 6: