Objective: To assess the effects of laryngeal mask and endotracheal intubation on intragastric insufficiency and postoperative outcome in laparoscopic surgery by ultrasonographic measurement. Methods: Sixty American Society of Anesthesiologists (ASA) I or II patients aged 20–65 years, with BMI <35 kg/m2 undergoing gynecologic laparoscopic surgery lasting less than 3 h were randomized into two groups according to the ventilation tools: a laryngeal mask group (group I) and a tracheal tube group (group T). Anesthesia was induced with intravenous injection of midazolam, sufentanil, cisatracurium, and etomidate. After the consciousness disappeared, the volume control was ventilated for 120 s, and the laryngeal mask or tracheal tube was inserted according to the group. The hemodynamic parameters with heart rate and blood pressure were recorded in the moment of before the induction (base values T0), the moment of before catheter immediately (T1), the moment of finishing catheter immediately (T2), the moment of after operating (T3) and the moment of after extubation immediately (T4). The antero-posterior diameter and craniocaudal diameter of the antrum were measured by the ultrasound and the antral cross-sectional area were calculated before induction of anesthesia (T5), after induction (T6), and at the end of surgery (T7). The complications of postoperative nausea and vomiting, sore throat, hoarseness was also recorded postoperatively. Results: Compare with group I, the hemodynamic parameters in group T at T2 and T4 were significantly higher (P<0.05). The hemodynamic parameters in both groups were significantly decreased when compared with those at T0. SBP, DBP and HR were increased significantly at T2 in group T when compared with those at T1 (P<0.05), also increased significantly at T4 when compared with those at T3 (P<0.05). The cross-sectional area of gastric antrum at T7 in group I was significantly smaller than that in group T (P<0.05). Compared with group I, the rate of postoperative sore throat and hoarseness was increased significantly in group T (P<0.05). Conclusion: The application of the I-gel laryngeal mask may result in a small amount of gas into the stomach, but does not cause serious complications such as reflux aspiration, which can be safely applied to gynecological laparoscopic surgery.