Objective To conduct a retrospective study on the clinical efficacy with endoscopic linea alba plication (ELAP) in the treatment of postpartum diastasis recti abdominis muscles. Methods Clinical data was collected to study the patients with postpartum diastasis recti abdominis muscles treated by ELAP in our hospital from January 2018 to December 2021. The operation was performed successfully in 48 cases. One case was lost follow-up and 47 cases were included in this study. Mean age was (34.9±4.2) years with body mass index (BMI) (20.1±2.0) kg/m². The index of patients included general data, intraoperative data and postoperative recovery. Follow-up was done through out-patient examination and B-mode ultrasonography until to March 2022. Results The inter-rectus distance (IRD) in umbilical area (M3) shown by ultrasound examination was (41.6±8.2) mm. There were 10 cases combined with umbilical hernia and 2 cases with linea alba hernia. ELAP was performed under general anesthesia. All hernia rings were closed by suturing. The operative time was (130.9±36.0) min. Visual analog scale was (1.2±0.6) on the 1st postoperative day with postoperative hospital stay (1.5±0.9) d. Two cases had mild seroma postoperatively with puncture and absorption under B-ultrasound guiding. Remaining cases were without operative complications such as bleeding and infection of incision. Followed up of 47 cases was completed in the period of median 15(12, 26) months. One case had mild pain in the operative site and cured after non-operative treatment. Ultrasound examination in the other case showed 57.0 mm of IRD in M3 area preoperative and normal in the follow-up of 1 month postoperative. However, there was mild recurrence on 3 months of follow-up showing IRD 21.0 mm. Conclusions ELAP could be considered safe and effective in the treatment of postpartum diastasis recti abdominis muscle.