Abstract: Endometriosis is an estrogen-dependent disease which normally happened in reproductive age. During the menopause, some ectopic lesions regress by reason of lacking estrogen, but there are still a part of lesions persist or emerge, even canceration, which brings difficulties for clinical treatment. At present, the mechanisms of postmenopausal endometriosis remain a subject of controversy and still need more research. Compared to reproductive patients, clinical manifestations of postmenopausal endometriosis are atypical. Most patients have subclinical signs that need multiple examinations to diagnose and follow-up visit. Surgery is the first choice of treatment in women with postmenopausal endometriosis. In patients with recurrence or who cannot tolerate surgery, aromatase inhibitors has shown an certain curative effect, although more studies are needed before clinical application.