Chocolate cysts are endometriosis, a phenomenon in which the endometrium is implanted on the ovaries. Although they are not tumors, they cause considerable effects, especially difficulties in fertility. Therefore, fertility should be fully considered in the management. Many inexperienced doctors often ignore this problem and either delay the reproductive function by untimely treatment or over-treat it. This results in many patients having decreased ovarian function or being prone to recurrence after surgery. These outcomes are sometimes irreversible. Chocolate cyst surgery is a very difficult procedure that must be done by a surgeon with considerable experience, and the surgeon must not only be skilled but also have considerable patience. Patients should be careful in choosing their surgeon.