Background: Endometriosis is a benign disease of the female genital system characterized by a chronic growth of endometrial-like tissue, consisting of glands and/or stroma, found outside the uterine cavity in sites other than the uterine cavity like the pelvic cavity, ovaries, pouch of Douglas, and uterosacral ligaments. The commonest symptom that women present to health services is pelvic pain, which usually begins before menses and continues along the duration of menstrual flow. Objectives: This study aims to review the recent updates in prevalence, presentation, complications, and updated management of endometriosis in Saudi Arabia. Methods: PubMed database and EBSCO Information Services were used for articles Screening. All Saudi papers concerning the prevalence, presentation, complications, and updated management of endometriosis and other articles have been used in making the article. We excluded additional papers that are not relevant to this topic. The data were collected as per the particular manner in which the group members would study it. Conclusion: Endometriosis significantly affects the quality of life and health of the patient and may lead to infertility. Effective surgical treatment should be used with a clinical diagnosis of endometriosis. Furthermore, knowledge of the different atypical presentations and imaging methods used to diagnose endometriosis is the responsibility of the clinician, and the importance of awareness cannot be ignored.