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Objective: To compare and analyze the clinical efficacy and complication rate of abdominal myomectomy with those of laparoscopic myomectomy in uterine fibroids. Methods: This study was carried out from January 2021 to January 2023 on 150 patients with uterine fibroids. The patients were divided into two groups, a study group (n = 75) and a control group (n = 75), by digital table grouping. Patients in the control group underwent abdominal myomectomy, whereas patients in the study group underwent laparoscopic myomectomy. Surgery-related indicators, incidence of complications, ovarian function indicators, recurrence rate, and pregnancy rate were compared between the two groups. Results: The surgery-related indicators of the study group were lower than those of the control group (P < 0.05 ); the incidence of postoperative complications was lower in the study group than in the control group (P < 0.05); the postoperative ovarian function indicators of the study group were lower than those of the control group (P < 0.05); there were no significant differences in postoperative recurrence rate and pregnancy rate between the two groups (P > 0.05). Conclusion: For patients with uterine fibroids, abdominal myomectomy and laparoscopic myomectomy have similar recurrence and pregnancy rates, but laparoscopic myomectomy can shorten the recovery time and reduce the incidence of complications and the impact on ovarian function. Therefore, the latter should be applied in clinical settings.