OBJECTIVE To compare differences between laparoscopy and laparotomy in managing women ruptured corpus luteum with hemoperitoneum. METHODS Three-year, prospective, nonrandomized study (Canadian Task Force classification II-2). METHODS University-affiliated regional hospital. METHODS Sixty hemodynamically stable women. METHODS Laparoscopic surgery (30 women) and laparotomy (30). RESULTS Laparoscopic surgery had significant advantages over laparotomy, including shorter hospital stay (55.33 +/- 7.67 vs 97.77 +/- 14.45 hrs, p < 0.001) without increased adverse events. Laparoscopic surgery also showed trends of shorter operating time, improved wound care, and less postoperative pain. CONCLUSIONS Laparoscopy surgery for diagnosis and treatment of women with ruptured hemorrhagic corpus luteum appears superior to laparotomy. We suggest that surgeons try laparoscopy first as a diagnostic and probably therapeutic procedure.