Whether or not to operate on a chocolate cyst depends on the individual patient’s condition. Surgery is recommended in cases where the localized lesion worsens or the ovarian cyst is large and affects fertility. Chocolate cysts are ovarian endometriosis cysts. With the development of the disease, cyclic bleeding occurs in the cyst, the pressure inside the cyst is high, and the wall of the cyst is prone to rupture, causing symptoms such as acute abdomen. At the same time, larger cysts can compress the bladder and bowel causing difficulty in urination and defecation. Therefore, surgery is recommended for larger chocolate cysts. Surgery is also recommended in cases where symptoms are not relieved by medication, localized lesions worsen, and fertility is affected. Surgery includes fertility preserving surgery, ovary preserving surgery and radical surgery. It is recommended to consult a doctor in time and choose an appropriate treatment plan under the guidance of your doctor.