Abstract:Endometriosis presents a common challenge in global women’s health. Ferroptosis, as an emerging form of regulated cell death, has recently attracted attention in relation to endometriosis. In terms of disease mechanisms, ferroptosis drives ovarian endometrial fibrosis via the induction of iron overload, and promotes disease progression by regulating multiple signaling pathways, such as p38 mitogen-activated protein kinase/signal transducer and activator of transcription 6(p38MAPK/STAT6), promote angiogenesis,autophagy,etc,fueling disease progression. In terms of infertility, ferroptosis affects embryo development and ovarian function, thereby reducing fertility. From a diagnostic perspective, high expression of ferroptosis-related genes provides potential biomarkers for the early diagnosis of endometriosis, effectively distinguishing patients from healthy individuals, and showing important clinical value. In terms of treatment strategies, non-natural compounds such as Erastin, as well as natural compounds such as resveratrol, ursolic acid, and baicalein, have shown potential therapeutic effects in relieving the pathological process and related symptoms of endometriosis. This review comprehensively elucidates the key role of ferroptosis in endometriosis in terms of the disease mechanisms, infertility, diagnosis, and treatment, and explores its potential as a diagnostic biomarker and therapeutic target, thus providing new theoretical support and treatment strategies for the management of endometriosis.