The article discusses endometriosis, a common gynecological condition characterized by endometrial-like tissue outside the uterus, leading to pelvic pain and infertility. It outlines the clinical presentation, diagnostic methods, and treatment strategies for endometriosis. Endometriosis affects 6 to 10% of women of reproductive age, with symptoms including dysmenorrhea, dyspareunia, and pelvic pain. Diagnosis is typically confirmed through surgical visualization, and staging is based on the extent and location of lesions. Non-surgical methods like transvaginal ultrasound and MRI have limited accuracy in detecting peritoneal and ovarian implants. Medical treatments for endometriosis-related pain include nonsteroidal anti-inflammatory drugs (NSAIDs), combined oral contraceptives, and gonadotropin-releasing hormone (GnRH) agonists. GnRH agonists can induce a hypoestrogenic state, which may lead to bone loss, so add-back therapy with estrogen and progestin is often recommended. Surgical options include excision, ablation, and nerve interruption, with laparoscopic surgery being a common approach. Post-surgical management may involve medical therapy to prevent recurrence. Endometriosis is also associated with infertility, and various treatments, including in vitro fertilization (IVF), are effective. However, the effectiveness of these treatments varies, and there is ongoing research into better diagnostic tools and therapies. The article highlights the challenges in diagnosing endometriosis, the need for multidisciplinary care, and the importance of long-term management to address both pain and fertility issues. It also notes the lack of robust data on the optimal management of endometriosis, particularly regarding the balance between medical and surgical approaches, and the impact on future fertility. The article concludes with recommendations for evaluating and treating endometriosis, emphasizing the importance of early diagnosis and appropriate management to improve quality of life and fertility outcomes.The article discusses endometriosis, a common gynecological condition characterized by endometrial-like tissue outside the uterus, leading to pelvic pain and infertility. It outlines the clinical presentation, diagnostic methods, and treatment strategies for endometriosis. Endometriosis affects 6 to 10% of women of reproductive age, with symptoms including dysmenorrhea, dyspareunia, and pelvic pain. Diagnosis is typically confirmed through surgical visualization, and staging is based on the extent and location of lesions. Non-surgical methods like transvaginal ultrasound and MRI have limited accuracy in detecting peritoneal and ovarian implants. Medical treatments for endometriosis-related pain include nonsteroidal anti-inflammatory drugs (NSAIDs), combined oral contraceptives, and gonadotropin-releasing hormone (GnRH) agonists. GnRH agonists can induce a hypoestrogenic state, which may lead to bone loss, so add-back therapy with estrogen and progestin is often recommended. Surgical options include excision, ablation, and nerve interruption, with laparoscopic surgery being a common approach. Post-surgical management may involve medical therapy to prevent recurrence. Endometriosis is also associated with infertility, and various treatments, including in vitro fertilization (IVF), are effective. However, the effectiveness of these treatments varies, and there is ongoing research into better diagnostic tools and therapies. The article highlights the challenges in diagnosing endometriosis, the need for multidisciplinary care, and the importance of long-term management to address both pain and fertility issues. It also notes the lack of robust data on the optimal management of endometriosis, particularly regarding the balance between medical and surgical approaches, and the impact on future fertility. The article concludes with recommendations for evaluating and treating endometriosis, emphasizing the importance of early diagnosis and appropriate management to improve quality of life and fertility outcomes.