Endometriosis is defined as the presence of endometrial like tissue outside the uterus which induces a chronic, inflammatory reaction. The condition is predominantly found in reproductive age, from all ethnic and social groups. The associated symptoms can impact on general physical, mental, and social well-being in all over the life of the patient. Therefore it is crucial to give a careful note to women's complaint and history and make a precise decision. Treatment must be individualized taking the impact of the disease and the effects of treatment into account. For a pain management before any decision for surgery, a multidisciplinary clinic including pain manager, psychologist, physical medicine, nutritionist, and gynecologist must be involved. And then the first line of treatment of pain should be medical. For infertility, the first line of treatment should be IUI or IVF. Although there is some evidence that the success of infertility treatment and ART is lower in the presence of endometriosis, but the side effects of early surgery and decrease ovarian reserve and recurrence rate of 20-50% after surgery should be included into account.