BACKGROUND Hysteroscopic surgery has been widely used in clinical practice for more than 30 years due to its advantages of less trauma, less bleeding, and direct vision. The aim of this study was to compare hysteroscopic morcellation versus conventional resectoscopy for removal of endometrial lesions. MATERIAL AND METHODS For the database search, we used the keywords "morcellator," "morcellators," "morcellate," "morcellation," and "morcellated" combined with "hysteroscopy," "hysteroscopy," "uteroscope," and "transcervical". The last search was conducted on February 1, 2022. Randomized controlled trials (RCTs) were included in the meta-analysis. RESULTS According to our retrieval scheme and the inclusion and exclusion criteria, we found 6 studies including 565 patients. For enumeration data, we calculated the effect size as relative risk (RR) and 95% confidence interval (95% CI), while for quantitative data we used the weighted mean difference (WMD) and 95% confidence interval (95% CI). There was no significant difference between success rate of hysteroscopic morcellation and conventional resectoscopy (relative risk and 95% confidence interval 1.05(0.97,1.13); P=0.232). Procedure time was also shorter with hysteroscopic morcellation, the procedure time of the hysteroscopic morcellation group was 3.43 min shorter compared with the conventional resectoscopy group, and the operating time in the hysteroscopic morcellation group was 2.81 min shorter. In terms of fluid deficit, there was no statistically significant difference in fluid loss between the 2 groups (P=0.209). CONCLUSIONS Hysteroscopic morcellation is associated with a shorter procedure time and operative time among patients with endometrial lesions compared with resectoscopy.