Background: Although laparoscopic surgery has multiple superiority to laparotomy, upper abdominal pain and shoulder pain has newly developed after performing laparoscopy. To control the respiratory variance occurred by pneumoperitoneum effectively during laparoscopy, traditionally general anesthesia was performed. However, general anesthesia has several disadvantages; damage on airway due to intubation, postoperative nausea/vomiting (PONV), slow recovery compared to spinal anesthesia. Several previous studies proved the safety and usefulness of spinal anesthesia in laparoscopic cholecystectomy. As previous studies are limited to the general surgery field and research on the gynecological field is lacking. Methods: This study was conducted at Wonju Severance Christian Hospital from September 2018 to May 2019. Total 11 patients were enrolled prospectively and underwent SPA laparoscopic adnexal surgery under spinal anesthesia. The intensity of postoperative pain by visual analogue scale score (VAS) and the intensity of PONV by emesis score (0-3) at 0, 2, 6, 12, 24, 48 hours after surgery was checked. Results: No case was converted to general anesthesia. The median long axis of ovarian cyst was 5cm (range, 3-7cm), and median total operation time was 38 minutes (range, 22-54min). 4 patients showed hypotension during operation, but all patients were well controlled with ephedrine 40mg intravenous injection. No patients complained pain nor nausea during operation. Postoperative pain checked 0, 2, 6, 12, 24, 48 hours after operation was 0(0), 3(2.5), 4.2(3.0), 3.1(2.9), 2.5(1.9), 1.7(2.2), and emesis score checked 0, 2, 6, 12, 24, 48 hours after operation was 0.1(0.3), 0(0), 0.2(0.6), 0(0), 0(0), 0.3(0.9). No postoperative complication was noted. Conclusions: Performing SPA laparoscopic adnexal surgery under spinal anesthesia is feasible. We are performing prospective study comparing spinal anesthesia and general anesthesia for SPA laparoscopic adnexal surgery.