INTRODUCTION: Endometriosis affects an estimated 1 in 10 women during their reproductive years which are approximately 176 million women in the world. It is an enigmatic disease often called an “Invisible Illness” with severe consequences. Endometriosis is an estrogen–dependent disorder that can result in substantial morbidity, including pelvic pain, multiple operations, and infertility. Surgical or medical therapy is efficacious for pelvic pain due to endometriosis. Operative laparoscopy for endometriosis consists of electro cautery or laser destruction of endometriotic implants and adhesiolysis. AIMS AND OBJECTIVES: To determine whether laparoscopic surgery enhanced fecundity in infertile women with moderate to severe endometriosis. MATERIALS AND METHODS: We discuss a prospective study of women diagnosed with infertility due to endometriosis, presenting with different symptoms, evaluated with ultrasound pelvis and CA–125 and managed by operative laparoscopy. RESULTS: Of the 13 women who presented with endometriosis to our hospital 84% women reported symptomatic improvement in terms of reduced pain following laparoscopic surgery. Out of 8 women who presented with infertility, 3 patients (37.5%) reported spontaneous conception following operative laparoscopy with an EFI score >5 (moderate endometriosis). Post operatively 6 (46%) of the 13 women were started on Tab Dienogest 2mg OD for 3 months and all reported symptomatic improvement with reduced pain and more than 1 month amenorrhoea or minimal spotting per vagina. IVF had been advised for 4 of the 8 patients with infertility with severe endometriosis with EFI score