The European Medical Journal has reported on new international guidance that critically highlights persistent unmet needs in the diagnosis, management, and long-term support for individuals living with endometriosis. This updated guidance, which likely refers to the comprehensive 2022 guidelines from the European Society of Human Reproduction and Embryology (ESHRE), calls for earlier recognition and more integrated reproductive healthcare pathways. Endometriosis, a chronic inflammatory condition affecting an estimated one in ten women of reproductive age globally, remains significantly underdiagnosed, with many patients experiencing delays of several years before receiving appropriate evaluation. These diagnostic delays contribute to prolonged pain, reduced quality of life, and adverse impacts on fertility and mental health. A key recommendation from the updated guidance emphasizes recognizing endometriosis based on symptoms rather than solely relying on surgical confirmation, a significant shift from previous practices. The guidelines now suggest laparoscopy only when imaging results are negative or empirical treatment proves ineffective or unsuitable. The importance of multidisciplinary management, integrating gynaecology, pain management, mental health support, and fertility counselling, is also underscored. Treatment plans are advised to be individualized and re-evaluated over time, especially as reproductive goals change. Globally, stark inequities exist in how endometriosis is recognized and treated, with nearly half of all countries lacking national policies or clinical guidance on diagnosis or care. In India, endometriosis is estimated to affect approximately 42-43 million women, yet it often remains underdiagnosed and misunderstood, posing significant challenges to effective symptom management. Experts highlight socioeconomic and medical obstacles, including high costs, stigma, lack of primary care provider education, and limited access to specialists, contributing to these unmet needs. The global reviews call for urgent action from governments, medical societies, and patient advocacy groups to collaborate on creating and promoting clear, region-specific endometriosis care standards to reduce diagnostic delays, improve quality of life, and ensure equitable access to treatment worldwide. This reinforces the critical need for improved awareness, research, and comprehensive health policies to address this debilitating condition effectively.