Ms. X, 46 years old, had her right ovary removed 10 years ago due to severe dysmenorrhea and right ovarian chocolate cyst. One year after surgery, another ovarian chocolate cyst appeared on her left ovary and gradually worsened, and her lower abdominal pain worsened significantly in the last three months. She was unable to live and work. Ultrasound: 3.43.7 cm echogenic light mass in the posterior wall of the uterus and 5.29.1 cm liquid dark area in the left adnexal region. Diagnosis: adenomyosis and left ovarian chocolate cyst. A dissection was performed and the fixed part of the uterus was adherent to the rectum, and the greater omentum and appendix were adherent to the original left adnexal surgery site. The uterus was gradually excised in pieces and the adhesions to the rectum were separated. Part of the greater omentum and appendix were removed. The left ovarian chocolate cyst was removed but the left ovary was preserved and she is now pain free. Her previous stomach pain was due to adhesions of the appendix to the right adnexal area. The appendix was already chronically inflamed. Ovarian chocolate cysts are often combined with adenomyosis, for which there is no good conservative treatment, and this patient had already given birth, so this procedure was performed with satisfactory results. The various pharmacological treatments currently prevalent, such as GNRHa and progesterone have limited effect and have more serious side effects. Therefore, diseases requiring surgery without surgery treated with medications will only labor. Patients with chronic abdominal pain should be operated with caution and the cause should be clarified as much as possible before surgery.