Objective: To compare the effects of ultrasonography with laparoscopy on transcervical resection of septa (TCRS). Materials and Methods: The study included 126 patients with uterine septum at the present hospital between January 2010 and August 2012 that were randomly divided into two groups. Seventy patients had TCRS monitored by ultrasound (ultrasound group) while 56 patients were monitored by laparoscope (laparoscope group). Both groups were followed up for six to 24 months. The intraoperative status, short-term and long-term complications after operation, and pregnancy outcome of two groups were compared. Results: The operations of both groups were successfully completed. The operating time, the first time to get out of bed, postoperative 24hNRS (numeric rating scale) values, postoperative hospital stay, and the incidence of postoperative septum residue of ultrasound group were significantly less than laparoscope group (p < 0.05). No statistical differences were observed in intraoperative complications and pregnancy ratio between the two groups. Conclusion: Both ultrasound and laparoscope monitored TCRS were safe and effective in the treatment of uterine septum. Ultrasound monitored TCRS was more simple, economical, accurate, and non-invasive. For patients without abnormal lesions in pelvic cavity, the present authors tend to choose the ultrasound monitored TCRS.