Objective：This study aims to investigate the effects of lithotomy on the hemodynamics of lower limbs in patients with gynecologic pelvic tumor whose lower limbs restored horizontally for 5 min after placing lithotomy position during the operation. Methods：From October 2018 to August 2019，101 patients with gynecological pelvic tumor surgery were enrolled in our study. They were randomly divided into two groups，51 patients in the experimental group and 50 patients in the control group. Experimental group received adjustable multi-function stirrup leg rack to obtain lithotomy position，and their legs were restored horizontally for 5 min every one hour. The control group received conventional leg rack until the end of surgery. The great saphenous vein pressure of the two groups patients were monitored before anesthesia（T0），at the beginning of lithotomy position（T1），1 h（T3），2 h after surgery（T3），and at the end of surgery（T4）. The upper and lower limb of perfusion index（perfusion index，PI），pulse rate and blood oxygen saturation （SpO2） were recorded and compared. Results：Compared with T0，venous pressure of lower extremity in T1-T4 group increased significantly（P < 0.01）. Compared with the control group，the fluctuation of venous pressure in the experimental group of T2~T4 was less，and the stability was significantly better than that in the control group（P < 0.05）. However，there was no significant difference between two groups at T1. Compared with T0，the lower limb PI of T1-T4 in the two groups was significantly reduced（P < 0.05）. Compared with the control group，the lower limb PI increased significantly（P < 0.05）at T2 and T3 but not T4 in the experimental group. There was no difference in upper limb PI，blood oxygen saturation and pulse rate between the two groups（P > 0.05）. Conclusion：Lower limbs restoring horizontally for 5 min every hour can reduce lower limb hemodynamic changes for those lithotomy position surgery with more than two hours longer. It might be beneficial to prevent deep vein thrombosis.