Endometriosis is a debilitating condition characterized by high recurrence rates and often causes pelvic pain and infertility. While 20-25% of patients are asymptomatic, the disease can significantly impact a woman's quality of life. Current treatments aim to manage symptoms, resolve existing implants, and prevent new foci of ectopic endometrial tissue, but they are not curative. A combination of medical, surgical, and psychological treatments can improve quality of life, though their benefits have not been fully demonstrated, especially in terms of long-term fertility. Randomized controlled trials are needed to evaluate the efficacy of different treatments. Endometriosis is associated with a lower live birth rate and is more common in infertile women. The relationship between endometriosis and infertility is complex, involving pelvic anatomy distortion, endocrine and ovulatory abnormalities, and altered peritoneal function. Surgical removal of endometriotic implants and assisted reproductive technologies (ART) are effective treatments for infertility associated with endometriosis. A multidisciplinary approach, including surgery and ART, has shown high success rates in reducing pain, improving quality of life, and enhancing fertility. However, there is insufficient data to determine the optimal treatment for mild-stage endometriosis, and radical surgery is recommended for severe cases involving rectovaginal disease.Endometriosis is a debilitating condition characterized by high recurrence rates and often causes pelvic pain and infertility. While 20-25% of patients are asymptomatic, the disease can significantly impact a woman's quality of life. Current treatments aim to manage symptoms, resolve existing implants, and prevent new foci of ectopic endometrial tissue, but they are not curative. A combination of medical, surgical, and psychological treatments can improve quality of life, though their benefits have not been fully demonstrated, especially in terms of long-term fertility. Randomized controlled trials are needed to evaluate the efficacy of different treatments. Endometriosis is associated with a lower live birth rate and is more common in infertile women. The relationship between endometriosis and infertility is complex, involving pelvic anatomy distortion, endocrine and ovulatory abnormalities, and altered peritoneal function. Surgical removal of endometriotic implants and assisted reproductive technologies (ART) are effective treatments for infertility associated with endometriosis. A multidisciplinary approach, including surgery and ART, has shown high success rates in reducing pain, improving quality of life, and enhancing fertility. However, there is insufficient data to determine the optimal treatment for mild-stage endometriosis, and radical surgery is recommended for severe cases involving rectovaginal disease.