Endometriosis is a common gynecological disorder affecting 5-10% of women of reproductive age, characterized by the presence of endometrial-like tissue outside the uterus, primarily in the pelvic peritoneum, ovaries, and rectovaginal septum. The disease is often underdiagnosed, with a delay of up to 9 years between symptom onset and diagnosis. Endometriosis is classified into four stages based on lesion size, location, and extent, but this staging system does not correlate with pain symptoms or infertility risk. The etiology of endometriosis is complex, with several contributing factors, including Sampson's retrograde menstruation theory, coelomic metaplasia, embryonic rest theory, vascular and lymphatic metastasis, tissue injury and repair theory, denervation-reinnervation theory, stem cell theory, and genetic/epigenetic theory. Hormonal dysregulation, particularly estrogen dominance and progesterone resistance, plays a significant role in the pathophysiology of endometriosis. The inflammatory response and immune dysregulation are also crucial, involving various immune cells and cytokines such as IL-6, IL-8, IL-1, TNF-α, and TGF-β. Fibrosis is a key component of endometriosis, leading to scarring and disruption of tissue anatomy. Infertility is a primary concern, affecting 35-50% of women with endometriosis, often due to distorted anatomy, inflammation, and hormonal imbalances. MicroRNAs (miRNAs) have been identified as important regulators in the development and progression of endometriosis, influencing processes such as inflammation, cell proliferation, and angiogenesis. Current management and treatment options for endometriosis include medical and surgical approaches, with laparoscopy being the gold standard for visualization and detection. Medical treatments focus on pain relief and fertility enhancement, while surgical interventions aim to alleviate symptoms and improve quality of life.Endometriosis is a common gynecological disorder affecting 5-10% of women of reproductive age, characterized by the presence of endometrial-like tissue outside the uterus, primarily in the pelvic peritoneum, ovaries, and rectovaginal septum. The disease is often underdiagnosed, with a delay of up to 9 years between symptom onset and diagnosis. Endometriosis is classified into four stages based on lesion size, location, and extent, but this staging system does not correlate with pain symptoms or infertility risk. The etiology of endometriosis is complex, with several contributing factors, including Sampson's retrograde menstruation theory, coelomic metaplasia, embryonic rest theory, vascular and lymphatic metastasis, tissue injury and repair theory, denervation-reinnervation theory, stem cell theory, and genetic/epigenetic theory. Hormonal dysregulation, particularly estrogen dominance and progesterone resistance, plays a significant role in the pathophysiology of endometriosis. The inflammatory response and immune dysregulation are also crucial, involving various immune cells and cytokines such as IL-6, IL-8, IL-1, TNF-α, and TGF-β. Fibrosis is a key component of endometriosis, leading to scarring and disruption of tissue anatomy. Infertility is a primary concern, affecting 35-50% of women with endometriosis, often due to distorted anatomy, inflammation, and hormonal imbalances. MicroRNAs (miRNAs) have been identified as important regulators in the development and progression of endometriosis, influencing processes such as inflammation, cell proliferation, and angiogenesis. Current management and treatment options for endometriosis include medical and surgical approaches, with laparoscopy being the gold standard for visualization and detection. Medical treatments focus on pain relief and fertility enhancement, while surgical interventions aim to alleviate symptoms and improve quality of life.