Diagnosis of endometriosis according to TVS may be an appropriate alternative method for laparoscopy. Hence in this study, the role of TVS was investigated compared with laparoscopic assessment in cases with pelvic endometriosis attending to imaging center of Imam-Khomeini and Yas Hospital in Tehran in 2018. In this diagnostic study, 69 patients with pelvic endometriosis were assessed. The results of TVS were compared with laparoscopic assessment, and the sensitivity, specificity, and congruence rate were determined. According to the obtained results, it may be concluded that most sensitivity of TVS is related to the torus uterinus and dome of the bladder. Also, the most specificity is related to bladder, sigmoid colon, and peritoneal cyst. The most congruence rate between U/S and laparoscopy is at bladder trigon and sigmoid colon. However, in the end, multicenter studies with more cases and comparisons with the results of other diagnostic methods are recommended to achieve more accurate results.