Retroperitoneal lymphadenectomy is an important component of surgical staging and the removal of metastatic lymph nodes in gynecologic malignancies, but its staging value does not necessarily translate into a survival benefit. As clinical evidence accumulates, sentinel lymph node mapping becomes more widely used, and risk assessment based on pathological and molecular features improves, nodal surgery is moving from routine systematic dissection toward individualized assessment and selective lymphadenectomy. For patients who still require dissection, advances in laparoscopic, robotic, and transumbilical single-port surgery, together with appropriate selection of transperitoneal or extraperitoneal access, offer more options to reduce surgical morbidity. Selecting suitable patients and limiting complications without compromising the adequacy of dissection remain key clinical concerns. This review discusses the indications, extent of dissection, surgical approaches, and advances in minimally invasive techniques for retroperitoneal lymphadenectomy in cervical, endometrial, and ovarian cancers. It examines the benefits and limitations of the procedure in meeting staging and treatment needs while preserving long-term quality of life.