Objective To discuss the clinical impact of laparoscopic surgery combined with GnRH-a for endometriosis infertility. Methods From June 2013 to June 2014, 88 endometriosis infertility patients were selected and divided into study group and the control group by the random number table method. The patients in study group were treated with laparoscopic surgery combined with GnRH-a. The patients in control group were treated with only laparoscopic surgery. The clinical efficacy, ovarian function and pregnancy outcomes of the patients in two groups were compared and analyzed. Results Compared with control group, the patients in study group, the clinical treatment for endometriosis achieved complete remission rate was 65.91 % (29/44) and total effective rate was 93.18 % (41/44), there were increased significantly, and the recurrence rate was 2.27 % (1/44), there was decreased significantly, after statistical analysis, the differences were significant statistically (P < 0.05). Compared with control group, the patients in study group after treatment, the level of E2 was (80.96 ± 17.65) ng/L, there were increased significantly, while the level of LH was (10.94 ± 3.20) IU/L and FSH was (6.24 ± 1.38) IU/L, there were decreased significantly, after statistical analysis, the differences were significant statistically (P < 0.05). Compared with control group, the patients in study group, the pregnancy rate was 47.73 % (21/44) and the living rate was 45.45 % (20/44), there were increased significantly, while the not pregnancy rate was 52.27 % (23/44), there was decreased significantly, after statistical analysis, the differences were significant statistically (P < 0.05). Conclusions Laparoscopic surgery combined with GnRH-a could improve the clinical efficacy of endometriosis infertility patients effectively, and further improve the ovarian function of patients, improve the pregnancy rate significantly.