Background <p>Efficient allocation of gynecological resources in tertiary hospitals is crucial to ensuring high-quality healthcare services. This study aims to evaluate the efficiency of gynecological resource allocation in tertiary hospitals across Jiangsu Province, China, using Data Envelopment Analysis (DEA).</p> Methods <p>We analyzed 126 tertiary hospitals using DEA with input indicators of medical staff numbers and available beds, and output indicators of outpatient visits, discharged patients, and bed utilization rates. The constant returns to scale (CRS, CCR) and variable returns to scale (VRS, BCC) models were employed to calculate technical efficiency (TE), pure technical efficiency (PTE), and scale efficiency (SE).</p> Results <p>Only 3.17% of hospitals achieved fully technically efficient (TE = 1), while 92.86% exhibited decreasing returns to scale. Significant variations in efficiency scores were observed among hospitals and cities. Slack analysis provided targeted recommendations for inefficient hospitals, quantifying required improvements in outpatient visits, patient discharges, and bed utilization rates.</p> Conclusions <p>Most tertiary hospitals’ gynecology departments face challenges in resource utilization and output optimization. This research offers valuable insights for healthcare administrators and policymakers to enhance resource allocation efficiency in gynecological services, potentially improving overall healthcare delivery in the region.</p> Clinical trial number <p>Not applicable.</p>