PURPOSE: The purpose of this study was to compare desflurane anesthesia with desflurane-remifentanil anesthesia by measuring postoperative pain, nausea and vomiting after gynecologic laparoscopic surgery. METHODS: Data were collected using a random double blind method. The experimental group treated with desflurane-remifentanil anesthesia had a total of 25 patients. The control group had 20 patients who were treated with desflurane anesthesia. Pain (VAS), pushing PCA button, nausea and vomiting (VAS) were assessed at PACU (Post Anesthesia Care Unit) arrival, 10 min, 20 min, 30 min in PACU and 2 hrs, 6 hrs, 24 hrs, 48 hrs in ward. INVR was assessed at 24 hrs. Extra analgesics and extra antiemetics were measured in PACU and the ward. Data were analyzed using t-test and repeated measure using ANOVA. RESULTS: The experimental group presented with more postoperative pain (F=7.55, p<.001) than the control group. The experimental group took more extra analgesics in PACU and pressed the PCA button more often for 6 hours. The experimental group complained more postoperative nausea (F=2.11, p=.043) than the control group and took extra antiemetics during postoperative period of 24 hours. CONCLUSION: We conclude that desflurane-remifentanil anesthesia needs better management than desflurane anesthesia due to increased pain, nausea & vomiting after gynecologic laparoscopic surgery.