Chronic pelvic pain (CPP) in adolescent women is a frequent complaint. We assessed the value of laparoscopy in the differential diagnosis of CPP in 47 adolescents 11-19 years old after six months or more of cyclic or acyclic pelvic pain. No pelvic abnormalities were detected in 19 patients (40.4%), endometriosis was detected in 18 (38.3%) (frequently with nonpigmented or "nonclassic" lesions), partially obstructive genital tract malformations were found in 4 (8.4%), and other types of pathology were discovered in 6 (12.8%). Nearly 60% of the patients had a treatable pelvic disease. Laparoscopy is an invaluable tool in the diagnosis of CPP in adolescents and should be performed before starting a psychiatric evaluation or prescribing long-term medical treatment.