To explore the clinical effect of the combined operation under uterinesparing laparoscopic pelvic plexus ablation (USLPPA) for treating patients with adenomyosis who had needs of reproduction. Methods: 102 patients with adenomyosis were included from January 1, 2015 to March 31, 2017. According to the needs and surgical plans, these patients were divided group A (patients with USLPPA but without pregnancy and fertility function reserved requirement), group B (patients with USLPPA and fertility function reserved requirement), and group C (patients with fertility function reserved requirement but without USLPPA). The operative quality, clinical efficacy, clinical indexes, and quality of life of the patients were compared among the three groups. Results: There were no significant differences in intraoperative blood loss, postoperative exhaust time, and hospital stay among the three groups. After operation, the menstrual bleeding of the patients in group A and B had decreased significantly, their dysmenorrhea symptoms had improved significantly, their uterine volume had decreased significantly, and their quality of life scores had improved significantly. The postoperative remission rate and recurrence rate of the patients in group A and B had no significant different after operation (all P＞0.05). However, the postoperative pregnancy rate (76.5%) of adenomyosis of the patients in group B was significant higher than that (44.1%) of the patients in group C (P＜0.05). Conclusion: The combined operation under USLPPA for treating patients with adenomyosis has better effect, and their postoperative pregnancy rate has improved, which is suitable for young patients with adenomyosis who want to fertility function reserved.