The history of surgery has witnessed a remarkable evolution with the widespread adoption of minimally invasive techniques, notably operative video laparoscopy. This study aims to shed light on the laparoscopy experience in a rural hospital in Eastern Sudan and contribute to understanding its outcomes and challenges in low-resource settings. This study systematically collected and analyzed data encompassing patient demographics, preoperative assessments, postoperative complications, and gender. The purpose was to derive insights and draw meaningful conclusions from this information. Among the 124 laparoscopic procedures scrutinized, laparoscopic ovarian cystectomy emerged as the most frequently performed intervention. Diagnostic laparoscopy for tubal examination and ovarian drilling were also prominent procedures. The patient cohort spanned a wide age range, from 25 to 55 years, with an average age of 30.5 years. Preoperative ultrasound scans unveiled crucial findings such as polycystic ovaries and cysts of varying sizes. The analysis highlighted significant correlations between cyst size, wall thickness, operative duration, symptom duration, and conversion rates. The range of operative time spanned from 9 to 150 minutes, with an average of 40.1 minutes. While a few cases necessitated conversion from laparoscopy to open intervention, no instances of mortality were reported. The introduction of laparoscopic gynecological procedures in the Eastern Sudan regional hospital has ushered in enhanced surgical outcomes for specific conditions. However, to further elevate this practice, emphasis must be placed on augmenting medical staff training and optimizing infrastructure. Expanding the scope of laparoscopic procedures, particularly in emergency gynecology and major surgeries, is pivotal. These concerted efforts will not only facilitate the diffusion of laparoscopy but also contribute to elevated patient care standards and the overall advancement of surgical gynecology in the region.