Gynecological laparoscopic surgery is a common minimally invasive procedure, but postoperative recovery quality remains an important clinical concern. This study aimed to evaluate the effects of transcutaneous electrical acupoint stimulation (TEAS) on the quality of recovery in patients undergoing gynecological laparoscopic surgery. In this prospective, randomized, single-blind, controlled trial, patients scheduled for gynecological laparoscopic surgery under general anesthesia at a tertiary hospital in China between April and December 2022 were enrolled. Participants were randomized into the TEAS group and the control group. In the TEAS group, bilateral stimulation of Neiguan, Zusanli, and Hegu acupoints was initiated 30 minutes before anesthesia induction and maintained until the end of surgery. In the control group, electrodes were applied without electrical stimulation (sham procedure). The primary outcome was the incidence of postoperative nausea and vomiting (PONV) within 24 hours. Secondary outcomes included the Quality of Recovery-40 (QoR-40) scores, Pittsburgh Sleep Quality Index (PSQI) scores, pain intensity assessed by numerical rating scale (NRS), and patient-controlled analgesia (PCA) usage. A total of 85 patients completed the study (TEAS group, n=42; control group, n=43). The incidence of 24-hour PONV was significantly lower in the TEAS group compared to the control group (42.9% vs 67.4%, P=0.023). QoR-40 scores at 48 hours postoperatively were significantly higher in the TEAS group (P<0.001). Additionally, the TEAS group exhibited lower blood glucose levels 30 minutes after skin incision (P=0.045), reduced intraoperative remifentanil consumption (P=0.031), fewer total and effective PCA demands (P=0.004 and P=0.039, respectively), and earlier recovery of gastrointestinal function (all P<0.05). Perioperative TEAS effectively reduces the incidence of early postoperative nausea and vomiting and enhances recovery quality in patients undergoing gynecological laparoscopic surgery, but the improvements in QoR-30 scores were statistically significant but not clinically significant. These benefits may be attributed to attenuated stress responses, improved sleep quality, and decreased analgesic requirements.