Objective To explore the curative effect of laparoscopic removal of giant myoma on the posterior wall of the uterus after pretreatment with leuprolide acetate. Methods A retrospective analysis of 97 patients with giant posterior fibroids received in our hospital from January 2018 to July 2019. Grouped according to the treatment plan, 48 patients who underwent laparoscopic posterior giant fibroids treatment directly as a control group, 49 patients who underwent laparoscopic posterior uterine myomectomy after pretreatment with leuprolide acetate were used as the observation group. The observation group was analyzed for changes in uterine volume and fibroids volume before and after pretreatment. The two groups were related to surgery. Indicators (operation time, intraoperative blood loss, time to get out of bed for the first time, length of hospital stay), the recurrence rate of fibroids in 3 months after operation. Results After pretreatment, the volume of uterus and fibroids in the observation group were smaller than those before pretreatment (P<0.05); the operation time, time to get out of bed for the first time, and hospital stay in the observation group were shorter than those of the control group, and the blood loss during operation was less than that of the control group (P<0.05). Three months after the operation, the recurrence rate of fibroids was 2.04% (1/49) in the observation group and 6.25% (3/48) in the control group, there was no significant difference (P>0.05). Conclusion The pretreatment of leuprolide acetate for injection can significantly reduce the size of uterine fibroids and uterus, help shorten the operation time of laparoscopic posterior wall huge myomectomy, reduce intraoperative damage, and speed up postoperative recovery. Surgery after treatment is an effective treatment for giant uterine fibroids in the posterior wall.