Endometriosis has been studied for more than 100 years, but to date, none of the proposed therapeutic strategies has provided a complete cure or avoided recurrence of the disease. This review considers current treatment options for endometriosis according to the pathogenetic principle, discusses the advantages and disadvantages of each of them. It remains difficult to define a window of opportunity for the treatment of endometriosis. There are currently no recognized treatment methods that prevent the development of this pathology; there is no evidence for the role of pharmacotherapy as an adjuvant to surgery, and it remains unclear how to treat disease recurrence. Therefore, new therapeutic targets in the treatment of this complex pathology are considered from the perspective of recent data on the pathogenesis of endometriosis. © 2023, Dynasty Publishing House. All rights reserved.