Objective To explore the feasibility of total laparoscopic hysterectomy （TLH） in the treatment of complex uterine fibroids. Methods From January 2017 to December 2019, a total of 76 patients with complex uterine fibroids who received surgical treatment were selected. All patients met the indications of total hysterectomy. According to the random number table method, they were divided into two groups： the control group （38 cases） was treated with total abdominal hysterectomy （TAH）, and the study group （38 cases） was treated with TLH. The operation indicators, postoperative complications, and ovarian function were compared between the two groups. Results The study group showed lower intraoperative blood loss and VAS score at 6 h after operation than the control group, and shorter postoperative exhaust time, ambulation time, and hospitalization time （all P<0.05）. The incidence rate of postoperative complications in the study group （5.26%） was lower than that in the control group （21.05%） （P<0.05）. There was no significant difference in the levels of LH, FSH, and E2 between the two groups before operation （P>0.05）; three months after operation, the levels of LH and FSH in the two groups were increased compared with those before operation, while the level of E2 was decreased （P<0.05）, but there was no significant difference between the two groups （P>0.05）. Conclusion TLH in the treatment of complex uterine fibroids features less intraoperative blood loss, lower postoperative pain, faster recovery, and fewer complications, thus has important application value.