Objective To compare the clinical value of suspended laparoscopic surgery and pneumoperitoneum laparoscopic surgery in treatment of uterine leiomyoma. Methods 106 uterine leiomyoma patients from May 2013 to April 2014 were randomly divided into two groups: observation group: using 1.5 hole method of abdominal wall subcutaneous gasless laparoscopic uterine fibroids resection and control group: gasless laparoscopic uterine fibroids resection. The postoperative complications and incidence of complications were compared between the two groups. Results The average operation time in observation group was (62.04 ± 18.69) min, removal of fibroids (5.83 ± 1.29); the average operation time in control group was (104.36 ± 20.14) min, removal of fibroids (2.45 ± 1.38). The intraoperative bleeding, anal exhaust time, postoperative drainage volume and hospitalization time in patients of observation group were significantly lower than that in control group (P < 0.05). In observation group, 3 cases (5.66 %) have cough, 2 cases of (3.77 %) have urinary retention. The total incidence rate was 9.43%. In control group, 8 cases (15.09 %) have cough, 1 case (1.89 %) have wound infection, 3 cases (5.66%) have urinary retention, 5 cases (9.43%) have subcutaneous emphysema. The total incidence rate was 32.07%. Conclusions The postoperative complication rate of gasless laparoscopic uterine fibroids resection was significantly lower than that of gasless laparoscopic surgery. It has the advantages of easy operation and high safety.