<p>Endometriosis (EM) is a chronic, estrogen-dependent inflammatory disease affecting approximately 10% of women of reproductive age worldwide, causing debilitating pelvic pain, infertility, and substantially impaired quality of life. Conventional hormonal therapies and surgery are limited by systemic side effects, high recurrence rates, and failure to maintain adequate drug concentrations at ectopic lesion sites. Nanotechnology-based drug delivery has emerged as a promising strategy for directing therapeutic agents to ectopic lesion sites, potentially reducing the systemic toxicity that limits current pharmacological options. We systematically review three nanomaterial platforms—hydrogels, extracellular vesicles (EVs), and inorganic nanoparticles—with attention to their physicochemical properties, therapeutic rationale, and preclinical findings, as well as the specific strengths and unresolved limitations of each platform. We further compare how each platform addresses the core pathological processes of EM, namely, persistent inflammation, progressive fibrosis, and pathological angiogenesis. We hope that this review will assist researchers in comparing nanocarrier strategies and identifying more realistic pathways for clinical application in EM.</p>