Objective To analyze the clinical efficacy of laparoscopic fallopian tube fenestration and embryo retrieval surgery for ectopic pregnancy， and to explore its impact on ovarian reserve function and re-pregnancy in patients. Methods A total of 86 patients with ectopic pregnancy admitted from January 2020 to January 2023 were selected as research subjects， and divided into a control group （odd number） and an observation group （even number） with 43 patients in each group， based on their admission numbers. The control group underwent salpingectomy on the affected side， while the observation group underwent laparoscopic fenestration and embryo retrieval. The levels of serum anti-Mullerian hormone before and after surgery， the number of postoperative sinus follicles after surgery， and the rate of postoperative re-pregnancy were compared between the two groups of patients. Results Before surgery， there was no statistically significant difference in serum levels of anti-Mullerian hormone between the two groups of patients of different age groups （P>0.05）. At 3 months after surgery， the serum levels of anti-Mullerian hormone in the observation group aged 20-30 and 31-35 years were higher than those in the control group （P<0.05）. At 6 months after surgery， there was no statistically significant difference in the serum levels of anti-Mullerian hormone between the two groups of patients aged 20-30 and 31-35 years （P>0.05）. The number of sinus follicles in the observation group was higher than that in the control group at 3 and 6 months after surgery （P<0.05）. The intrauterine pregnancy rate in the observation group was higher than that in the control group at 12 months after surgery， and the infertility rate was lower （P<0.05）. Conclusion Laparoscopic fallopian tube fenestration and embryo retrieval surgery can protect ovarian reserve function and reproductive function in patients with ectopic pregnancy， and help improve the rate of intrauterine re-pregnancy after surgery.