The decision to operate on a chocolate cyst depends on the patient’s own condition and the size of the lesion. Surgery is usually recommended for cysts ≥ 4 cm in diameter. Ovarian chocolate cysts, also known as ovarian endometriotic cysts, refers to the endometriosis of the uterine lining grows to the ovary to form a cyst, and the stale blood inside the cyst forms a coffee-colored viscous liquid, which resembles a chocolate-like consistency. Cysts <4 cm in diameter usually do not require surgery and can be treated medically. Surgery is generally recommended for patients with cysts ≥4 cm in diameter, obvious dysmenorrhea, and fertility requirements. Surgery can be conservative or radical. Conservative surgery is generally used for young, fertile patients. All visible foci of ectopic endometrium are removed or destroyed, and the uterus, one or both ovaries, and at least part of the ovarian tissue are preserved. Radical surgery is used for patients over 45 years of age with no fertility requirements. All ectopic endometrial lesions in the uterus, both adnexa and pelvis are removed or eliminated. Patients with chocolate cysts are advised to go to the hospital in time for standardized treatment. If severe pain occurs before or after menstruation or after coitus, there is a possibility of rupture of the cyst, you should go to the hospital in time.