Objective To discuss the intervention value of gonadotropin-releasing hormone agonist (GnRH-a) adjunctive therapy combined with laparoscopic surgery for patients with ovarian endometriotic cysts (OEC), and to evaluate its effects on postoperative recurrence rates and ovarian function. Methods A retrospective analysis was conducted on the clinical data of 72 patients with OEC who underwent laparoscopic treatment in Shangqiu Municipal Hospital from January 2023 to December 2024. Based on whether GnRH-a therapy was administered postoperatively, the patients were divided into a combined group (n＝36) and a control group (n＝36). The combined group received subcutaneous injections of GnRH-a, while the control group did not receive GnRH-a. The visual analog scale (VAS) scores at different postoperative time points, ovarian function-related indicators [anti-mu? llerian hormone (AMH), follicle-stimulating hormone (FSH), estradiol (E2) ] at 3 months postoperatively, 12-month recurrence rates, and postoperative complication rates were compared between the two groups. Results The VAS scores in the combined group were both significantly lower than those in the control group at 3 months and 12 months postoperatively (both P＜0.05). At 3 months postoperatively, the AMH level in the combined group was significantly higher than that in the control group, while the FSH level was significantly lower (both P＜0.05). No statistically significant difference was observed in E2 levels (P＞0.05). The 12-month recurrence rate in the combined group was 8.33%, significantly lower than that in the control group (25.00%) (P＜0.05). No statistically significant difference was found in complication rates between the two groups (P＞0.05). Conclusion GnRH-a adjunctive therapy combined with laparoscopic surgery can effectively alleviate postoperative pelvic pain in patients with OEC , reduce recurrence rates, and provide certain protection for ovarian function.