Office sonovaginography (SVG) challenges the concept of the "normal" pelvic ultrasound in women with chronic pelvic pain and suspected endometriosis. When positive for posterior compartment deep infiltrating endometriosis, with or without Pouch of Douglas obliteration, office SVG allows for triaging of women to the appropriately trained advanced laparoscopic gynaecological and colorectal surgical team. We advocate that all women with suspected endometriosis undergo office SVG prior to laparoscopy to ensure an accurate pre-operative mapping of endometriosis disease location and extension.