This study aimed to compare the postoperative analgesic effect and safety between oxycodone and fentanyl in gynecological laparoscopic surgery, so as to provide a basis for further clinical application of oxycodone. Seventy-six patients undergoing gynecologic laparoscopic surgery were randomly divided into oxycodone and fentanyl groups, with 38 cases in each group. The anesthesia methods are basically the same in two groups. In addition, before abdominal closure, oxycodone hydrochloride was intravenously injected in oxycodone group, and fentanyl was intravenously injected in fentanyl group. Results showed that, the analgesic effect was similar between oxycodone and fentanyl in the early stage after gynecological laparoscopic surgery. However, oxycodone had better analgesic effect than fentanyl on visceral pain. In addition, the incidence of adverse reactions in oxycodone group was significantly lower than fentanyl group. Oxycodone is suitable for application to gynecological laparoscopic surgery.