Objective To investigate the effect of different doses of esketamine on the quality of early recovery in patients after laparoscopic hysterectomy. Methods A total of 105 patients who underwent laparoscopic hysterectomy from October 2021 to March 2022 were enrolled. According to the random number table method, the patients were divided into three groups (n=35): an esketamine 0.3 mg/kg group (group L), an esketamine 0.5 mg/kg group (group H) and a control group (group C). Group L and group H were given intravenous injection of esketamine 0.3 mg/kg and 0.5 mg/kg, and group C was given intravenous injection of normal saline solution in a similar volume. Their general information, the duration of operation, anesthesia time and extubation time were recorded. The 40‑item Quality of Recovery Scale (QoR‑40) scores (QoR‑40 total scores as well as the scores of physical comfort, emotional state, self‑care ability, psychological support, and pain), the State Anxiety Inventory (SAI) score and the Montgomery‑Asberg Depression Rating Scale (MADRS) score were recorded on preoperative day 1, and postoperative days 1 and 2. The Numerical Rating Scale (NRS) scores were evaluated at postoperative 30 min, 2 h, 12 h and 24 h and the incidence of postoperative adverse events were also recorded. Results There was no significant difference in QoR‑40 total scores as well as the scores of physical comfort, emotional state, self‑care ability, psychological support and pain, SAI and MADRS scores among the three groups on preoperative day 1 (P>0.05). Compared with those on preoperative day 1, QoR‑40 total scores and the scores of physical comfort, emotional state, self‑care ability and pain in the three groups decreased on postoperative day 1 (P<0.05); while the MADRS scores increased on postoperative days 1 and 2 (P<0.05), and QoR‑40 total scores as well as the scores of physical comfort, emotional state, self‑care ability and pain, and SAI scores in group C decreased on postoperative day 2 (P<0.05). In group L and group H, SAI scores showed decreases and MADRS scores showed increases on postoperative day 1 (P<0.05), and QoR‑40 total scores as well as the scores of physical comfort and self‑care ability, and SAI scores showed decreases on postoperative day 2 (P<0.05). And the emotional state and pain scores in group L showed decreases on postoperative day 2 (P<0.05). Compared with group C, group L and group H showed increases in the QoR‑40 total scores as well as the scores of physical comfort, emotional state and pain, and decreases in the SAI and MADRS scores on postoperative days 1 and 2 (P<0.05), and decreases in the NRS scores at postoperative 30 min, 2 h, 12 h and 24 h (P<0.05). Meanwhile, group H presented a decrease in the incidence of postoperative rescue analgesia (P<0.05). Compared with group L, group H showed increases in the QoR‑40 total scores as well as the scores of physical comfort and pain, and SAI and MADRS scores on postoperative days 1 and 2 (P<0.05), and increases in the emotional state scores on postoperative day 2 (P<0.05), and decreases in the NRS scores at postoperative 2 h and 24 h (P<0.05). There was no significant difference in the incidence of other postoperative adverse events among the three groups (P>0.05). Conclusions Intravenous injection of 0.3 mg/kg or 0.5 mg/kg esketamine during anesthesia induction can improve postoperative anxiety and depression, reduce postoperative pain score and improve the quality of recovery 2 d after laparoscopic hysterectomy. In terms of improving the overall recovery quality, 0.5 mg/kg esketamine was the best; while 0.3 mg/kg esketamine had better anti‑anxiety and depression effect.