Abstract The aim of this study is to assess the use of intraoperative transvaginal ultrasonography (TVS) to lo-cate deep myomas that were not identified on laparo-scopic view. The design of this study is a prospective observational study. This study was conducted in private Advanced Endoscopy and Infertility Treatment Centre, Kerala, India. The study comprised of 84 patients who underwent laparoscopic myomectomy from January
2011 to December 2013 in whom intraoperative TVS was used as an intervention. The number of additional deeper myomas removed was calculated, and recurrence at 1 year was calculated. The total number of myomas enucleated was 390, and the additional myomas enucle-ated after intraoperative TVS were 94. The recurrence of myomas at 1-year follow-up was 7.1 %. Intraopera-tive TVS was helpful to the surgeon for identifying deeper myomas making the surgery more effective.