Endometriosis is a chronic gynecologic condition associated with chronic pelvic pain and infertility. It is characterized by endometrial tissue outside the uterus, which can invade various organs and structures. Its pathophysiology is still under investigation, although it is likely secondary to a combination of retrograde menstruation, immune dysfunction, and coelomic metaplasia, amongst other contributing factors. Endometriosis may be difficult to diagnose as symptoms vary per individual. Common clinical presentations include pelvic pain, dysmenorrhea, dyspareunia, and infertility. Treatment depends on the patient’s symptoms and goals. Patients can opt for expectant management if asymptomatic. Nonsurgical options include a combination of nonsteroidal anti-inflammatory drugs and hormonal suppression via progestins, gonadotropin-releasing hormone agonists, or gonadotropin-releasing hormone antagonists. Surgical management involves excision. There are different techniques for excision of bowel and urologic endometriosis.