Endometriosis is a relatively common benign condition in women of reproductive age and is one of the main causes of secondary dysmenorrhea. Generally, there are two types of treatment, conservative and surgical, depending on the severity of the lesion. For milder lesions, short-acting oral contraceptives can be taken. For more severe dysmenorrhea, GnRHa pseudo-menopausal therapy can be applied, or high potency progestins can be used. However, pharmacological treatment mainly relieves symptoms and does not clear the lesions. For some patients with indications for surgery, surgical treatment is recommended. The main ones are ovarian chocolate cysts larger than 5 cm in diameter, infertility due to endometriosis, and severe pelvic pain due to deep infiltration of endometriosis for which drug therapy is ineffective. When a chocolate cyst is found on the ovary by ultrasound, many patients ask if it can be observed, or treated medically, or if the coeliac fluid can be aspirated by puncture. The current international consensus is that if a patient has never been treated for endometriosis, has never had surgery, has a coeliac cyst greater than 5 cm, or has severe dysmenorrhea, or has evidence of impaired fertility, the The preferred treatment remains surgery for the following reasons: (1) Once endometriosis has formed a cyst of a certain size, i.e., a chocolate cyst, drug therapy is not sensitive and it is clinically difficult, if not impossible, to eliminate the cyst through drugs. If you see advertisements or information that there are prescriptions, herbs, or what drug enemas can promise to eliminate chocolate cysts, you must pay attention to screening, but there are indeed patients who say, my cyst is small and disappeared after taking the medicine prescribed by a miracle doctor, then it can be roughly judged that the cyst is in all probability not a chocolate cyst, but a physiological cyst, which is very common in adult women and generally, without any treatment, disappears more than 3-6 months. The cyst will disappear naturally in 3-6 months without any treatment. (2) Some patients are afraid of surgery and refuse to operate, unknowingly the cyst may be “raised” very large, coarse cysts are not actively treated, very easy to occur around the period of spontaneous rupture, similar to acute abdomen, forcing patients to seek emergency medical care, in individual hospitals lacking experience in the treatment of this new type of acute abdomen, the lack of knowledge, usually for The patient undergoes a dissection operation, and at this time, the cyst is mostly accompanied by a severe inflammatory reaction, and the operation does not easily remove the cyst cleanly, even leading to the complete removal of one ovary, with relatively large losses for the patient. (3) The diagnosis of chocolate cyst given by the doctor can only be described as a general diagnosis, not every cyst in the stomach of every patient is a chocolate cyst, it may well be a tumor of a worse nature, or more harmful to the body, more affecting the health, surgery, to be able to remove the tumor and pathological examination, which is the only gold standard to confirm the nature of the tumor. (4) Coeliac disease is closely related to ovarian endometrioid carcinoma and clear cell carcinoma, and the malignant rate of coeliac disease is about 1%, so surgery can exclude the malignant change of coeliac disease, or avoid the long night and the change of the nature of the cyst. (5) Surgery can remove the pelvic mass more thoroughly, relieve dysmenorrhea and improve the quality of life of patients. (6) For patients with infertility problems, the pregnancy rate of patients can be improved after surgery, and most patients can get pregnant naturally six months after surgery. For recurrent coeliac disease after surgery, GnRHa pseudo-menopause therapy or high potency progestin can be used if the patient has concerns about reoperation, provided that coeliac malignancy is basically excluded.