To systematically investigate the clinical efficacy and prognosis of laparoscopic surgery combined with drug therapy for endometriosis.Clinical randomized controlled trials regarding laparoscopic surgery combined with drug therapy for endometriosis and published between 2010 and 2022 were retrieved from PubMed, Web of Science and Embase, China National Knowledge Infrastructure, and Wanfang databases. Meta-analysis and sensitivity tests were performed using the Stata16.0 software.A total of 1332 articles were retrieved. Of them, 11 studies were included for final analysis, comprising of 521 cases in the treatment group (laparoscopic surgery combined with drug therapy) and 530 cases in the control group (laparoscopic surgery alone). Meta-analysis results showed that compared with the control group, the combined treatment had higher treatment effective rate [OR = 4.542, 95% CI (3.062, 6.736), P < 0.001], pregnancy rate [OR = 3.341, 95% CI (2.336, 4.780), P < 0.001], and lower incidence of adverse reactions [OR = 0.348, 95% CI (0.208, 0.583), P < 0.001] and recurrence rate [OR = 0.187, 95% CI (0.106, 0.328), P < 0.001]. In addition, after treatment, estradiol [SMD = -3.417, 95% CI (-4.631, -2.203), P < 0.001] and follicle-stimulating hormone [SMD = -1.976, 95% CI (-3.202, -0.751), P = 0.002] in the treatment group were significantly lower than the control group.Compared with laparoscopic surgery alone, laparoscopic surgery combined with drug therapy demonstrated better clinical efficacy and improved postoperative infertility and recurrence rate for treating endometriosis.Copyright © 2022. Published by Elsevier Ltd.