The objective of this study was to determine the better method of myomectomy by comparing laparoscopic and open myomectomy for patients with fibroids with regard to operative parameters and outcomes. A systematic review was performed on published studies identified by the databases PubMed, EMBASE, the China Biological Medicine Datadase (CBMdisc), Ovid and the Cochrane Library, as well as cross-references. Randomized controlled trials on laparoscopic versus open myomectomy were assessed on operative parameters and outcomes. Six studies and 576 patients were studied. Analysis was performed using the statistical software Review Manager Version 4.2. The data available show that laparoscopic myomectomy was associated with less hemoglobin drop, reduced operative blood loss, more patients fully recuperated at day 15, diminished postoperative pain, and fewer overall complications but longer operation time. However, major complications, pregnancy and recurrence were comparable in the two groups. The data show that if performed by suitably specialized surgeons in selected patients, laparoscopic myomectomy is a better choice than open surgery.