Objective To compare the therapeutic effect of manual versus pressure‑controlled ventilations for lung recruitment maneuver during laparoscopic surgery. Methods A total of 90 patients undergoing elective laparoscopic gynecologic surgery were selected. According to the random number table method, they were divided into three groups (n=30): a blank control group (group A), a manual lung recruitment group (group B) and a pressure‑controlled ventilation group (group C). All the patients were mechanically ventilated in the volume controlled mode, with consistent ventilator parameters, and lung recruitment was performed every hour after endotracheal intubation and at the end of the operation (group A did not have lung recruitment maneuver, group B received lung recruitment maneuver by manual ventilation, and group C was subject to lung recruitment maneuver by pressure-controlled ventilation). Then, their mean arterial pressure (MAP), heart rate and pulse oxygen saturation (SpO2) were recorded 5 min before anesthesia induction (T0), 5 min after intubation (T1), before lung recruitment (T2), 10 min after lung recruitment (T3), after the operation (T4), and 15 min after extubation (T5). Furthermore, their dynamic lung compliance (Cdyn), peak airway pressure (Ppeak) and end‑tidal carbon dioxide partial (PETCO2) at T1‒T4 after endotracheal intubation were recorded. Pulmonary examination was performed at T0 and T5 and the effect of lung recruitment was evaluated by the modified Lung Ultrasound Score (LUS). The Clinical Pulmonary Infection Score (CPIS) on postoperative day 1 and the incidences of postoperative pulmonary complication (PPC) within seven days after the operation were recorded. Then, the operative time, and the times to anesthesia and extubation were recorded. Results There was no statistical difference in American Society of Anesthesiologists (ASA) grade, body mass index (BMI), age, the operative time, and the times to anesthesia and extubation among the three groups (all P>0.05). Furthermore, group A showed higher MAP, heart rate, Ppeak, and PETCO2 and lower SpO2 and Cdyn than group B and group C at T3 and T4 (all P<0.05). In contrast, increased MAP, heart rate and Cdyn as well as decreased Ppeak were found in group C, compared with those in group B at T3 and T4 (all P<0.05). Group A presented a higher modified LUS than group B and group C at T5 (all P<0.05), while the modified LUS at T5 in group B was higher than that in group C (P<0.05). Compared with those at T0, the three groups showed increases in modified LUS at T5 (all P<0.05). The CPIS score on postoperative day 1 and the incidence of PPC on postoperative day 7 in group A were higher than those in group B and group C (all P<0.05). There was no statistical difference in other indexes (all P>0.05). Conclusions Each of the methods can improve the degree of postoperative atelectasis and reduce the incidence of postoperative pulmonary inflammation to a certain extent. Meanwhile, pressure‑controlled ventilation has improved effect on airway improvement, with reduced effect on hemodynamics and a decreased incidence of postoperative atelectasis.