Diagnosis of endometriosis requires careful interpretation of objectiv
e surgical and pathologic findings in the context of the patient's cli
nical presentation. Clinical assessment helps to identify patients at
high risk of endometriosis and selects those who warrant further testi
ng. Determination of the serum level of CA-125, and to a lesser extent
, other proteins, may be helpful in evaluating selected population at
risk and following the course of the disease. Selective use of imaging
studies, especially ultrasound and magnetic resonance imaging, may al
so be helpful. Ultimately, the diagnosis of endometriosis is usually c
onfirmed or refuted by laparoscopy, preferably performed in conjunctio
n with histologic evaluation of excised lesions.