Abstract Objective: To compare effectiveness of topical 5-aminolevulinic acid-mediated photodynamic therapy (5-ALA PDT) and loop electrosurgical excision procedure (LEEP) among patients with cervical intraepithelial neoplasia (CIN). Design：Retrospective study. Setting：Department of Laser Medicine, the First Medical Centre, Chinese PLA General Hospital. Population or Sample：Female patients with a histologically confirmed CIN or HPV infection were treated by 5-ALA PDT or LEEP. Methods: Patients underwent either 5-ALA PDT or LEEP from Sep. 2012 to Dec. 2019 in Chinese PLA general hospital. Propensity score matching (PSM) was adapted to pair the baseline. Main Outcome Measures: Complete remission (CR), partial remission (PR) and the remission rate of HPV infections were used to evaluate the efficacy of 5-ALA PDT versus LEEP. Results 30 pairs were matched as the matching tolerance was set as 0.03. There was no significant difference about the CR and PR between 5-ALA PDT and LEEP group (73.33% vs 84.00%, P=0.340; 3.33% vs 4.00%, P=1.000). Among CIN1, 2, 3 group, there was also no statistic difference between 5-ALA PDT and LEEP. Moreover, in terms of HPV remission rate, 5-ALA PDT showed the same efficacy as LEEP (59.26% vs 53.85%, P=0.691). Conclusions In treating different types of CIN patients, Topical 5-ALA PDT is a successful, non-invasive, repeatable treatment with comparable results to LEEP.