Although endometriosis remains an enigmatic disease, recent pharmacologic and surgical ad' vances have dramatically improved our ability to deal with endometriosis-associated pain, infertility, and pelvic masses. This article summarizes the nature, presentation, and diagnosis of endometriosis and reviews the current medical and surgical treatment options. Prospective, con- trolled studies and meta-analyses provide an understanding of how best to utilize these new technologies. A rational, objective, and usually effective algorithm for management of this potentially debilitating disease can be implemented for most patients.