Objective　To investigate the anesthetic state during propofol-remifentanil anesthesia (TIVA) with Narcotrend® Monitor (NT) in Gynecological Laparoscopic Surgery. Methods　110 patients (ASA I or II) undergoing gynecological laparoscopic surgery were randomized into two groups: Anesthetic depth measured with NT group (Group N) and the control group (Group J) (n = 55). All were treated with standard induction of anesthesia, with intraoperative propofol-remifentanil TIVA to maintain. Group N adjusts the depth of anesthesia according to NT. Group J of adjusts the depth of anesthesia according to patients' heart rate, blood pressure and body automatically,et al. NT grading (NTS), the NT index (Narcotrend index，NTI), mean arterial pressure (MAP), heart rate (HR), and pulse oxygen saturation (SpO2) were recorded during induction, intubation, before pneumoperitoneum, after pneumoperitoneum, end of pneumoperitoneum, opening of eyes, extubation of endotracheal tube, and complete instructions (eight time points). The total amount of sedatives, analgesics, total muscle relaxant, awakening time, time to extubation, and intraoperative awareness were observed and recorded. Results　 There were no reports of intraoperative awareness in the post-anesthetic care unit in each group. There were no statistical significant differences in demographic characteristics or perioperative factors between group N and group J (P> 0.05). Compared with group J, the efficacy in maintenance of anesthesia was no significant difference in two groups (P> 0.05).And SpO2 no significant change (P> 0.05). However, Hemodynamic changes in group N were more stable. And the infusion dosage of propofol-remifentanil had been decreased in group N: group N [(320 ± 54) mg / (28 ± 11) μg] vs. group J [(450 ± 80) mg / (41 ± 11) μg] (P < 0.05).The time of analepsia was significant difference in two groups: group N (8 ± 4) min vs. group J (12 ± 6) min, and the patients of group N analepsiaed quickly and completely: group N (15 ± 5) min vs. group J (19 ± 9) min ( P < 0. 05). Conclusions　NT used as monitoring the depth of propofol-remifentanil TIVA was clinical significance in the safety of gynecological laparoscopic surgery. It could reduce unnecessary excessive use of intravenous general anesthetics.