Endometriosis (E) is an estrogen-dependent inflammatory disorder that is observed in approximately 10% of women in childbearing age, and is the most common benign gynecological disorder requiring hospitalization. In 5% of cases, there is an involvement of the gastrointestinal tract, for the most part of the sigmoid colon and rectum (~ 90%). However intestinal obstruction due to severe stenosis of the sigmoid colon, as in the case described by the authors, is rare. The differential diagnosis should include cancer, inflammatory diseases and actinic colitis which has a similar clinical picture to E. Surgical treatment - resection and anastomosis or conservative procedures - provides better results especially when a multidisciplinary approach is used (colorectal surgeon, gynecologist, urologist). The authors report a case of obstruction of the sigmoid colon due to endometriosis and analyze the pathophysiology, diagnosis and surgical management of this disorder.