Cold knife hysteroscopic myomectomy (CKHM) is a minimally invasive surgical technique used to remove submucosal fibroids, commonly associated with infertility. Methods: A comprehensive literature search was conducted across databases including PubMed, Scopus, and Google Scholar, focusing on studies published from 2011 to 2024. The aim of this narrative review was to highlight the minimally invasive cold loop resectoscopic approach for the treatment of submucosal fibroids. Results: The review revealed that CKHM is associated with favorable fertility outcomes, with studies reporting increased pregnancy rates; most studies indicated that CKHM did not negatively affect endometrial function. Conclusions: Cold knife hysteroscopic myomectomy is a safe and effective option for women with submucosal fibroids who wish to preserve fertility due its minimal invasiveness and low complication rates.