Abstract: Endometriosis is a relatively common condition in women of reproductive age. the pathogenesis and development of endometriosis are still poorly understood. The theory of retrograde menstruation with implantation of endometrial fragments，in conjunction with peritoneal factors to stimulate cell growth is the most widely accepted. Immunological factors and angiogenesis also influence the pathogenesis of endometriosis. Endometriosis lesions are inevitably exposed to ischaemia and hypoxia microenvironment that could adversely influence the initiation and progression of the disease. The present review highlights the fact that hypoxia play an important role in genesis of endometriotic lesions. hypoxia is connected with angiogenesis and apoptosis and immune injury of the endometriotic lesions. The effects of hypoxia can be protected by estrogen. Certain proangiogenic and antiangiogenic plant components have been used in traditional Chinese medicine （TCM） in healing endometrisis successfully. This review also explores the prospects of hypoxia on TCM therapies，which may be a new idea for endometriosis drug treatments.

Key words: Anoxia, Endometriosis, Estrogens, Apoptosis, Therapy