Chronic pelvic pain is a common debilitating condition affecting women and presents a major challenge to healthcare providers. Laparoscopy is the only test capable of diagnosing peritoneal endometriosis and adhesions. Gynaecologists have, therefore, seen it as an essential tool in the assessment of women with chronic pelvic pain. This article explores the role of surgery in the management of chronic pelvic pain. The approach to women with chronic pain must be therapeutic, supportive and sympathetic. Depending on the severity of disease found, ideal practice is to diagnose and remove the disease surgically at the same time during laparoscopy. A maximum surgical effort must be expended to resect all endometriosis, restore normal pelvic anatomy, resect nerve fibres and treat surgically accessible disease.