Deep infiltrative endometriosis (DIE) is a specific type of endometriosis common in women of reproductive age. This condition can manifest with severe pain, or it may progress silently without any symptoms. Asymptomatic patients often seek medical attention due to infertility. DIE is defined by the deep infiltration of endometrial-like tissue into structures such as the ligaments of the uterus between the vagina and rectum, bowel, bladder, ureters, and peritoneum. This condition requires a multidisciplinary approach, involving not only gynecology but also general surgery, urology, and gastroenterology. These tissues can remain asymptomatic until advanced stages, potentially leading to serious complications like bowel obstruction when they reach significant size. Surgical treatment for DIE must be performed by experienced surgeons. During surgery, meticulous dissection is critically important to free the area between the uterus and bowel, as well as the ureters. Often, removal of affected bowel segments and rejoining the remaining parts may be necessary. Given its significant impact on patients' social lives and the potential for severe adhesions, accurate diagnosis and effective treatment of deep endometriosis should be conducted by experienced professionals in well-equipped centers.