Thoracic and diaphragmatic endometriosis are two of the most common sites of extrapelvic endometriosis. Thoracic endometriosis refers to the presence of endometriotic implants within the thoracic cavity, and diaphragmatic endometriosis refers to the endometriotic implants encountered on the abdominal side of the diaphragm. As for thoracic endometriosis, catamenial pneumothorax is the most frequent symptom. The detection of endometrial implants via imaging is challenging, and a definitive diagnosis is typically confirmed through video-assisted thoracoscopic surgery (VATS). Pulmonary parenchymal endometriosis shows nodules, bullous changes, ground-glass opacities, consolidations, and linear opacities. Diaphragmatic endometriosis is often found in the right side with complaints from patients about cyclic right shoulder pain and is often associated with severe pelvic endometriosis. The recommended therapeutic approach for lesions on the abdominal side of the diaphragm involves hydrodissection followed by excision. Because these lesions are tiny punctate foci, they are not easy to recognize on computed tomography (CT) or magnetic resonance (MR) imaging. They can be found as hyperintense nodules or plaques on T1-weighted images on MR imaging.