Despite progress made in anesthesiology and operative gynecology, adequate postoperative analgesia remains an urgent problem. Nonsteroidal anti-inflammatory drugs (NSAIDs) have a wide use in the clinical practice of complex postoperative analgesia, but the elaboration of new regimens and the design of new medicaments are being continued. The optimization of NSAID use is associated with the elimination of its adverse events and complications with the high analgesic activity being maintained. Dexketoprofen is one of the NSAIDs that combine the best balance between efficacy and safety. The review considers the pathogenesis of pain, the mechanisms of analgesic action of NSAIDs, and the evidence base of the efficacy and safety of dexketoprofen, which permits it to be recommended for use in gynecological practice.