The advantages of laparoscopy in the treatment of benign disease have been well demonstrated. Compared to open surgery, laparoscopy is associated with a shorter hospital stay, less ileus, decreased postoperative pain, earlier return to work, and better cosmesis. The role of laparoscopy for the cure of malignant disease, however, remains controversial. In order to elucidate the safety and efficacy of laparoscopy for malignancy, worldwide large controlled randomized trials were developed. While awaiting the results of large randomized trials, a review of the many published studies to date was undertaken demonstrating a high level of evidence of the superiority of laparoscopy over laparotomy in regard to short-term benefits, when performed by appropriately skilled surgeons in properly selected patients. The data also suggest similar or superior local recurrence and long-term survival rates. However, further follow-up and review of large, multicenter, randomized trials will be needed before widespread acceptance of the technique can be recommended.