Endometriosis is one of the most frequently encountered benign diseases in gynecology. It is the cause of pelvic pain (dysmenorrhea, dyspareunia) and infertility in more than 35% of women of reproductive age [1]. Complete resolution of endometriosis is not possible, but therapy has essentially three main objectives: to preserve and improve fertility; to reduce pain; and to delay recurrence for as long as possible. The aim of this manuscript is to focus on fertility preservation in women with severe endometriosis.