Objective To investigate the effect of ear acupoint bean pressing on gastrointestinal motility and related hormones after laparoscopic surgery in patients with hysteromyoma，and to explore the therapeutic mechanism of ear acupoint bean pressing. Methods Patients undergoing laparoscopic myomectomy in the Department of Gynecology of The People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from May 2022 to December 2023 were randomly divided into an experimental group and a control group，with 57 patients in each group. The experimental group was treated with postoperative routine nursing and ear acupoint bean pressing （targeting the spleen，stomach，and sympathetic），and the control group was treated with postoperative routine nursing and sham ear acupoint bean pressing （containing no Vaccaria seed，targeting the spleen，stomach，and sympathetic）. After the intervention，the time to first postoperative passing of flatus and defecation，clinical efficacy，and changes in gastrointestinal hormone levels were compared between the two groups. Results The time to first postoperative passing of flatus ［20.31 （17.52，22.38） h vs. 21.51（18.53，28.15） h］ and defecation ［35.32 （31.47，39.17） h vs. 38.12 （33.44，42.78） h］ in the experimental group was lower than that in the control group（P<0.05），and the clinical efficacy was better than that in the control group（P<0.05）. There were no significant differences in motilin（MTL），gastrin（GAS），somatostatin （SS），and substance P（SP） levels between the two groups before operation（P>0.05）. The MTL and GAS levels were increased and the SS and SP levels were decreased after operation. The MTL［（451.52±54.33） pg/mL vs. （476.24±56.35） pg/mL］ and GAS［150.50 （133.93，164.52） pg/mL vs. 173.44 （154.45，184.63） pg/mL］ levels at 24 h after operation in the experimental group were lower than those in the control group（P<0.05），and the SS［38.34（33.24，40.23） pg/mL vs. 33.36（29.13，38.76） pg/mL］ level at 24 h after operation was higher than that in the control group（P<0.05），with no significant change in the SP level（P>0.05）. The results of repeated measures analysis of variance and generalized estimation equation showed that there were significant differences in the time effect and interaction effect of MTL（P<0.05），a significant difference in the time effect of SP（P<0.05），and significant differences in the time effect，intergroup effect，and interaction effect of GAS and SS（P<0.05）. Conclusion Ear acupoint bean pressing has significant effect on abdominal distension after laparoscopic surgery in patients with hysteromyoma，effectively regulates the level of gastrointestinal motility related hormones，and promotes the recovery of gastrointestinal function.