Bladder endometriosis is a specific form of endometriosis characterized by the presence of endometrial glands and stroma in the detrusor muscle. Such disease may involve different sites of the bladder, most frequently the base and the dome, with various grade of infiltration. Bladder nodules typically coexists with other localizations of deep pelvic endometriosis, resulting in a wide variety of abdominal and urinary symptoms that may be overlooked by clinicians. In spite of advances in understanding the genetic and molecular development of endometriosis, the clinical approach to bladder lesions is very challenging and may require the use of different diagnostic tools in order to set up a comprehensive diagnostic workup and direct towards the most appropriate treatment. The aim of this paper was to portray the state of art of diagnosis and management of bladder endometriosis, starting from the current evidence about epidemiology, pathophysiology, clinical signs and providing all the available strategies for medical and surgical treatment.