Minimally invasive techniques applied to gynecological fibroid surgery is another major advancement in medicine and is now widely used in developed countries as the surgical method of choice for fibroids. Uterine fibroids are the most common benign gynecological tumor in the female genitalia. They are most common in women aged 30-50 years, with the highest incidence in women aged 40-50 years, accounting for 51.2%-60%; it is estimated that about 20%-25% of women aged 35-50 years suffer from uterine fibroids. Treatment of uterine fibroids should be decided after thorough consideration of the patient’s age, symptoms, fibroid size, fertility and general health status. Expectant therapy is generally used for those with fibroids smaller than 8 weeks of gestation, no obvious symptoms, no complications and no fibroid degeneration, or near-menopausal women with uterus smaller than 12 weeks of gestation, normal menstruation and no symptoms of pressure, for temporary observation. Insist on review every 3-6 months, i.e., regular follow-up observation in clinical and imaging aspects, generally the fibroids can gradually shrink after menopause. However, it should be noted that the fibroids do not shrink but increase in size in a few patients after menopause, so follow-up should be strengthened. During the follow-up period, surgery should be considered for fibroids that increase in size and grow rapidly, submucosal fibroids or suspected myoma degeneration, or those with obvious symptoms and anemia. Myomectomy is mainly indicated for patients under 45 years of age, especially under 40 years of age, who wish to preserve their reproductive function. Myomectomy can be performed to preserve the uterus regardless of subplasma, interstitial, or even submucosal fibroids. Submucosal fibroids can be removed by hysteroscopic surgery, which is less painful for the patient and allows for a quick recovery, even on an outpatient basis. Submucosal fibroids with tissues that prolapse into the vagina can be removed vaginally. Minimally invasive laparoscopic myomectomy is feasible for subplasmalemma and interstitial myomas. Total hysterectomy should be performed for older patients with obvious symptoms and no requirement for further fertility, while one or both normal ovaries can be preserved to maintain their endocrine function at the age of about 50. Total hysterectomy can be performed via televised laparoscopy, transvaginal or open. Trans-laparoscopic or transvaginal surgery is the current trend in the development of gynecological surgery as it is less traumatic for the patient, has a quick recovery, leaves almost no scars, and has a short hospital stay. The technique uses a cold light source to provide illumination and a laparoscopic lens (3-10 mm in diameter) is inserted into the abdominal cavity. The images captured by the laparoscopic lens are transmitted to the posterior signal processing system using digital camera technology and are displayed in real time on a dedicated monitor. The doctor then uses the images of the patient’s organs from different angles displayed on the monitor screen to analyze the patient’s condition and perform the surgery with special laparoscopic instruments. During the operation, only three small holes of 0.5 to 1 cm are opened in the patient’s abdomen. After recovery, only 1-3 linear scars of 0.5-1 cm are left in the abdominal area, which are only the size of a keyhole, making it a minimally invasive and painful surgery. Minimally invasive surgery is currently the most effective way to treat uterine fibroids. The surgeon makes three small 5 mm-sized incisions in the patient’s abdomen in a hidden area and then puts in a laparoscope. A television monitor connected to the laparoscope provides a clear view of the magnified abdominal cavity and then operates the device left outside the patient’s body to perform the treatment. The operation does not require an open abdomen, is less traumatic, and the patient recovers quickly so that the patient’s own immunity is not lowered, infection is not likely to occur, no abdominal or pelvic adhesions will occur, and the integrity of the female reproductive organs, such as the uterus, can be preserved, and the fertility of women and a harmonious married life can be preserved.