To investigate the effect of low-dose ketamine combined with butorphanol for postoperative analgesia of patients with myomectomy, and to study its influence on the postoperative recovery of the patients. Methods: A convenient sampling method was used to select 110 patients who wanted myomectomy from January 2019 to November 2021. According to the random number table, these patients were divided into two groups(55 cases in each group). Postoperative patientcontrolled intravenous analgesia(PCIA) with butorphanol was given to the patients in the two groups for postoperative analgesia. The small dose ketamine was also given to the patients in the study group additionally. The visual analogue score(VAS) score and Ramsay sedation score in postoperative 6h, 12h, and 24h, the levels of serum stress indexes, such as  cortisol(Cor) and noradrenaline(NE), before operation and in postoperative 6h  and 24h, the scores of Pittsburgh Sleep Quality Index(PSQI) scale and 40-item Recovery Quality Score Scale(QoR-40) in postoperative 24h and 48h, the time of first defecation, the time of first independent activity, and the duration of hospital stay, and the adverse reactions rate of the patients were compared between the two groups. Results: The VAS score of the patients in the study group in postoperative 6h, 12h, and 24h was significantly lower than that of the patients in the control group, while the Ramsay score of the patients in the study group was significantly higher. The serum Cor and NE levels of the patients in the study group in postoperative 6h and 24h were significantly higher than those before operation, but which of the patients in the study group were significantly lower than those of the patients in the control group. The PSQ score of the patients in study group in postoperative 24h and 48h was significantly lower than that of the patients in the control group, and the QoR-40 score of the patients in the study group in postoperative 24h and 48h was significantly higher. The time of the first postoperative defecation(3.04±0.79d), the first voluntary activity(3.57±1.06d), and the duration of hospital stay(4.52±1.24d) of the patients in the study group were significantly less than those(4.18±1.25d, 4.96±1.37d, and 6.08±1.53d) of the patients in the control group(all P＜0.05). There was no significant difference in the total incidence of adverse reactions(10.9% vs.18.2%) of the patients between the two groups(P>0.05). Conclusion: The low-dose ketamine combined with butorphanol for postoperative analgesia of the patients with myomectomy can significantly improve their postoperative analgesic and sedative effects, can reduce their stress reaction, and can promote their recovery and sleep, with reliable safety.