Endometriosis is clinically most evident in dysmenorrhea, which tends to worsen progressively. The clinical presentation varies depending on where the endometrial tissue is located. If the tissue is located on the ovaries, it can form ovarian chocolate cysts. Generally, chocolate cysts can affect fertility, leading to anovulation and the appearance of ovarian chocolate-like cysts. Treatment typically involves surgical intervention, which is characterized by a high risk of recurrence after surgery. If there is no immediate plan for pregnancy, there is also a possibility of recurrence. Additionally, if endometriosis involves the uterus, it can lead to a uniformly enlarged uterus and uneven uterine wall echoes, resulting in adenomyosis. Therefore, the most typical clinical manifestation of endometriosis is progressively worsening dysmenorrhea.