This study was undertaken to evaluate the clinical usefulness of operative laparoscopy in treatment of benign ovarian cysts. A retrospective study was carried on 468 operative laparoscopy cases performed from September 1995 to September 1998 at Yonsei University College of Medicine, Department of Obstetrics and Gynecology. Patient characteristics, specimen pathology, perioperative morbidity, and perioperative complications were reviewed. The percentage of operative laparoscopy increased steadily from 20.7% in 1996, 33.9% in 1997, to 49.7% in 1998. The mean age of patients was 33.66.5 (mean +/- SD) years and the mean hospital stay was less than 2 days. Types of surgery performed were cystectomy (n = 234), salpingo-oophorectomy (n = 126), oophorectomy (n = 63), and fulguration (n = 45), in decreasing order. Depending on the pathology of the ovarian cyst, the mean operation time was in the range of 80 to 110 minutes. Perioperative complications included 5 cases of subcutaneous emphysema, 10 cases of abdominal wall hematoma, 7 cases of trocar site bleeding, 3 cases of bowel injury, and 1 case of bladder injury. In conclusion, operative laparoscopy in treating benign ovarian cysts provides advantages such as less need to perform laparotomy, smaller skin incision, less perioperative discomfort, minimal tissue handling and trauma, and shorter hospital stay. Nevertheless, the risk of unrecognized ovarian malignancy cannot be absolutely excluded, therefore careful patient selection is mandated.