BACKGROUND Laparoscopy is becoming common for the management of complex benign gynaecological diseases, in which considerable adhesions are expected, thus making the laparoscopic surgery more difficult to perform. AIMS To evaluate the efficacy and safety of laparoscopic surgery for adnexal tumours in post-hysterectomy women. METHODS In a retrospective study, we reviewed and analysed 40 post-hysterectomy women who were treated surgically for benign ovarian tumours at Kangbuk Samsung Hospital, from May 1999 to April 2007. Twenty women received laparotomic surgery and 20 were treated by laparoscopic surgery. Operating time, haemoglobin changes, complication rates, return of bowel activity, and duration of hospital stay were evaluated. RESULTS Operating time, haemoglobin changes, and complication rates were similar for both groups. For the laparoscopy group, the return of bowel activity was significantly faster (33 vs 45 h; P = 0.0131) and hospital stay was significantly shorter (four vs eight days; P = 0.0005) than for the laparotomy group. CONCLUSIONS Laparoscopic surgery for adnexal tumours in post-hysterectomy women might be an effective and safe alternative to laparotomic surgery. Surgical experience in this procedure and a thorough understanding of retroperitoneal anatomy from a laparoscopic view are mandatory to ensure low morbidity.