INTRODUCTION Endometriosis, the presence of endometrial tissue outside of the uterine cavity, is prevalent in 6 to 10% of the adult female population.1-3 In North America, more than 5.5 million women are affected.4 Women with endometriosis experience chronic pelvic pain, dysmenorrhea, dyspareunia, depression, and infertility. These symptoms are associated with missed work or school and impaired familial relationships. Despite the huge impact that endometriosis has on women and their families, delays in definitive diagnosis epidemiology, clinical presentation, and diagnosis. Factors that contribute to diagnostic delay and the potential impact of the disease on women and their families are also explored, and a strategy is provided to help primary care NPs appropriately evaluate, treat, and refer patients with suspected endometriosis.