Endometriosis, a common cause of morbidity in reproductive-age females, results in pelvic pain and infertility. Endometriosis-associated pain can be approached with surgical or medical therapies. Conservative surgery maintains reproductive organs and is effective in the treatment of endometriosis-associated pain. A more radical surgical approach of hysterectomy with bilateral salpingo-oophorectomy remains a mainstay of therapy for patients who have completed childbearing. Current medical therapies rely upon interruption of normal cyclic ovarian hormone production resulting in an environment not conducive to the growth of endometriosis. Genomics promises to further characterize endometriosis and tailor therapies based on a woman's symptoms and reproductive goals.