&NA;Endometriosis has been reported with increasing frequency in the literature in recent years, particularly endometriosis in nongynecological sites. Primary endometriosis of the ileum is of particular concern due to the high incidence of small bowel obstruction. The treatment in the past has been castration and resection of the affected bowel, with no guarantee of cure.Two cases are presented which indicate that the hormonal therapy with Danocrine and laser vaporization of endometriotic lesions involving the ileum may alter the natural history of progressive ileal obstruction. A comprehensive review of the literature was undertaken which revealed 204 reported cases of endometriosis of the ileum. New recommendations regarding management of small intestinal endometriosis are proposed.