Objective To analyze the characteristics and influencing factors of postoperative recurrence of ovarian endometrioma. Methods A retrospective analysis was performed on 475 patients with OMA who were treated in the First Affiliated Hospital of Anhui Medical University from January 2018 to January 2023, with 227 patients with postoperative recurrence in the study group and 248 with no recurrence in the control group. Results Combination with uterine fibroids （OR=1.823，95%CI 1.072-3.100），bilateral OMA （OR=1.968，95%CI 1.132-3.421），being accompanied by clinical symptoms （OR=2.491，95%CI 1.553-3.995），surgery during menstrual secretion （OR=1.930，95%CI 1.253-2.973），high surgical stage （OR=1.588，95%CI 1.204-2.095）and large primary cyst （OR=1.139，95%CI 1.027-1.263）increased the probability of postoperative recurrence. High Hb （OR=0.982，95%CI 0.967-0.999），postoperative drug therapy （OR=0.220，95%CI 0.126-0.384） and postoperative childbirth（OR=0.507，95%CI 0.290-0.887）reduced the probability of postoperative recurrence. The postoperative recurrence of unilateral primary OMA was more likely to occur on the primary side，and the recurrence of bilateral primary OMA was more likely to be on the left side. Conclusions Combination with uterine fibroids，bilateral OMA，being accompanied by clinical symptoms，surgery during menstrual secretion，high surgical stage，and large primary cyst are independent risk factors for postoperative recurrence of OMA. High Hb，postoperative drug therapy and postoperative childbirth are protective factors for postoperative recurrence. There is a certain correlation between primary OMA and recurrent OMA concerning the lateral distribution.