Abdominal wall endometriosis (AWE) is a rare variant of extrapelvic endometriosis that is characterized by the presence of endometriotic cells within the abdominal wall, primarily manifesting as pain and significantly impacting patients’ quality of life. Diagnosis can be challenging but typically involves the first-line use of abdominal ultrasound, followed by magnetic resonance imaging (MRI), which should include morphological sequences both with and without contrast enhancement. In complex cases, fine-needle aspiration (FNA) or percutaneous biopsy may be conducted. Hormonal therapy is the initial treatment approach, with surgical excision offered in cases of therapeutic failure. Although effective, surgery carries risks due to the anatomical and physiological complexity of the abdominal wall, including the need for prosthetic material implantation and an increased risk of recurrence over time. Minimally invasive interventional techniques have evolved over the years, showing promising results in terms of both pain management and cosmetic outcomes, with their use expanding globally through advances in interventional radiology (IR). Furthermore, basic research is crucial for enhancing our understanding of the pathophysiology of this condition and for optimizing treatment techniques to maximize efficacy while minimizing morbidity. Extensive multicenter prospective studies are needed to ascertain the definitive role of minimally invasive techniques in the therapeutic arsenal for treating endometriosis and to evaluate outcomes during follow-up.