Objective: Hysteroscopy has a positive role in the treatment of abnormal pregnancy, with less damage to the patient, good surgical effect, rapid postoperative recovery, and positive clinical value. This work aimed to explore the role and value of hysteroscopy in preserving the fertility of women with abnormal pregnancies., Methods: 60 patients with abnormal pregnancies in Maanshan Maternal and Child Health Care Hospital were enrolled from December 1, 2021 to December 31, 2022. They were grouped Based on treatment methods: controls (30 cases) and observation groups (30 cases). The average age of the control group was 30.66 ± 5.32 years, with a BMI of 23.36 ± 2.15 kg/m2, and an educational duration of 12.24 ± 3.61 years. The observation group had an average age of 30.18 ± 5.71 years, a BMI of 23.23 ± 2.53 kg/m2, and an educational duration of 12.33 ± 3.28 years. Controls adopted the traditional method (laparoscopic surgery), and an observation group was given with hysteroscopic localization and removal of pregnancy products. The surgical conditions, postoperative recovery, cure rate, complications, preoperative and postoperative blood human chorionic gonadotropin (HCG) level and 36-Item Short Form Health Survey (SF-36) score were compared between the two groups., Results: The observation group had a significantly shorter surgical time of 10.22 minutes, a postoperative hemostasis time of 7.32 days, a menstrual recovery time of 25.73 days, and a time for blood HCG turning negative of 10.76 days compared to the control group (P < .05). The observation group also experienced significantly less intraoperative bleeding, with 6.22 ml compared to 11.69 ml in the control group (P < .05). The cure rate of controls was 83.33%, and that of the observation group was 100.00%. The cure rate of the observation group was obviously higher as against controls. The incidence of complications in the observation group was 6.67%, and that in controls was 26.67%. The incidence of complications in the observation group was clearly lower as against controls. Through operation, the serum HCG levels of two groups were clearly decreased, the SF-36 scores were clearly increased, and the changes in the observation group were more obvious (P < .05)., Conclusion: Compared to traditional surgery, hysteroscopy examination demonstrates multiple advantages in the management of abnormal pregnancies, primarily attributed to its minimally invasive nature, high precision, minimal tissue trauma, and quick recovery. This contributes to providing a safer and more effective treatment, increasing patient satisfaction, and reducing healthcare costs, with a positive impact on patient care and clinical practice. However, this work had a relatively small sample size, a single source of patients, and a short duration, which necessitates future validation through the expansion of the sample size and multicenter research. A more comprehensive assessment of long-term postoperative effects is required to confirm the long-term advantages of this treatment method.