Endometriosis is a common estrogen-dependent disease in women of childbearing age, often leading to chronic pelvic pain, infertility, ovarian cancer, and other serious complications, and jeopardizing the health of women. The pathogenesis of endometriosis is complex and involves the alteration of multiple signaling pathways mediated by hormones, immunity, genetics, and the environment, and their interactions. Wnt / β-catenin signaling is involved in the regulation of embryonic development and tissue homeostasis, and it has recently been implicated in the pathogenesis of endometriosis via multiple pathways. This review considers the biological characteristics of the Wnt / β- catenin signaling pathway and summarizes the main mechanisms and signaling pathways involved in the pathogenesis of endometriosis, as well as the current research status of the regulation of this signaling pathway by traditional Chinese medicine for the treatment of endometriosis. We aim to clarify how the Wnt / β-catenin signaling pathway affects the development of endometriosis, and suggest that future studies should focus on exploring its potential role as an indicator for the clinical prediction and early diagnosis of endometriosis, thus providing theoretical support for the early diagnosis of this condition and the development of targeted drugs.