To compare laparoscopy to laparotomy for the surgical treatment of benign cystic teratomas. This was a retrospective, case series comparison of 20 patients who had surgery at Rochester General Hospital from June 1991 to January 1993 for benign cystic teratomas. Statistical comparisons were made by Student's t test or chi 2 analysis. Eight patients had surgery via laparoscopy and 12 via laparotomy. Laparoscopic oophorectomy and cystectomy resulted in significantly shorter hospital stays and decreased hospital costs, but the surgery time was significantly increased. The patients' fertility status influenced the choice of conservative cystectomy or nonconservative oophorectomy as the surgical procedure. There were no serious complications in any patients, including those with laparoscopic cystectomies and intraperitoneal spill. Oophorectomy and ovarian cystectomy via operative laparoscopy appear to be reasonable options for the surgical treatment of benign cystic teratoma.