Laparoscopic surgery has been the most significant advancement in our surgical practice in recent years. The essential attribute of laparoscopic surgery is the reduction of the surgical trauma of access [6]. Therefore, laparoscopic surgery is less invasive, less disabling and less disfiguring, allowing shorter hospital stay and faster recuperation [7]. However, true to the principle that “all operations carry some risk of complications,” laparoscopic surgery has its fair share of problems. An effective treatment modality always has benefits outweighing the risks. A comparative evaluation of different treatment modalities establishes the one with best benefit: risk profile as the favoured method. In light of this, I wish to critically evaluate the statement that “laparoscopic surgery is said to carry increased risk” by examining its role in present-day surgical practice. I shall also discuss how these risks can be reduced further and how to communicate the risks to our patients. Diagnostic laparoscopy has a definitive role in the investigations of chronic pelvic pain [39], endometriosis, suspected ectopic pregnancy and infertility, as it offers the advantage of visual inspection of the abdominal and pelvic organs over imaging techniques. The notion that “laparoscopy carries increased risk” has not been proved true in the case of laparoscopic sterilisation, which is the most common laparoscopic surgery performed worldwide. A systematic review evaluating the risks and benefits of laparoscopic sterilisation compared to mini-laparotomy [19] confirmed that the minor morbidity is significantly less following laparoscopic sterilisation and that there is no significant difference in the incidence of major morbidity associated with either method. For the surgical treatment of ectopic pregnancy, significant advantages with the laparoscopic approach have been demonstrated in many studies [22, 27, 40] and it is the preferred option over laparotomy in haemodynamically stable patients [30]. Laparoscopy has also become an increasingly preferred approach for adenexal surgery, such as the removal of benign ovarian tumours and prophylactic bilateral salpingo-oophorectomy (BSO). A systematic review of six randomised controlled trials (RCT) confirms that, in women undergoing surgery for benign ovarian tumours, the laparoscopic approach results in less post-operative complications, including pain, pyrexia, urinary tract infection, hospital stay and total cost compared to laparotomy [25]. Patients with polycystic ovarian syndrome (PCOS), who are resistant to ovulation induction with clomiphene, show no difference in live birth and miscarriage rates compared to gonadotrophin therapy when treated with laparoscopic ovarian drilling (LOD) using diathermy or laser. LOD has a significantly lower multiple pregnancy rate and is an attractive treatment option for ovulation induction for this condition [9]. Laparoscopy remains the gold standard for the diagnosis of endometriosis [29]. Laparoscopic treatment is effective for pain relief in minimal to moderate endometriosis [14] and for minimal and mild endometriosis to improve fertility [15]. For advanced and deeply infiltrative endometriosis, radical laparoscopic excision of all diseased areas results in improvements in pain score and the quality of life [12]. The risks of surgery are proportional to its extent and complexity. There are concerns in this area as laparoscopic hysterectomy (LH) takes longer to perform and has a higher incidence of intra-operative injury to the bladder and ureter Gynecol Surg (2006) 3:315–319 DOI 10.1007/s10397-006-0256-3