Endometriosis, despite being a benign and inflammatory condition, shows a significant clinical impact on women during their reproductive years, profoundly disrupting their quality of life, work productivity, and healthcare management. Three crucial considerations are necessary to ensure an optimal evaluation of patients with endometriosis before initiating appropriate treatment: adhering to a correct pelvic MRI protocol, employing an appropriate semeiotic lexicon for key findings, and generating structured reports with a scoring system. The pelvic MRI protocol is established on the basis of recommendations from the European Society of Urogenital Radiology. Key aspects include patient preparation (such as fasting, antiperistaltic agents, and bowel enemas), technical requirements (utilizing 1.5 T or 3 T machines), high-resolution sequences, and multiplanar acquisitions (including T2 and T1 sequences with and without fat suppression). The second consideration, MR lexicon, involves describing all disease-involved sites comprehensively to achieve thorough staging. This entails reporting the presence or absence of ovarian endometriosis, deepe infiltrating endometriosis, superficial endometriosis, and associated internal adenomyosis,n). Deep endometriosis should be described according a compartimental based analysis based a pelvic division defining two horizontal lines with an anterior line passing anterior to the cervix or vagina and a posterior line passing anterior to the rectum and two vertical lines passing from back to front by the USL and the underlying mesorectal fascia, the lateral border of the uterine cervix or vagina, and the lateral wall of the bladder Classification is based on the involved compartments (anterior, middle, posterior, and lateral). The final consideration pertains to structured reporting. The European Society of Radiology (ESR) has underscored the significance of optimized communication between patients and the imaging team to deliver patient-centered and value-based care. Standardized reporting descriptors can enhance interpretation agreement and communication, particularly with the introduction of a specific lexicon for endometriosis. Detailed and comprehensible MR reports are essential, especially given the challenges posed by extensive and complex surgeries. This clarity is crucial for accurately planning surgeries, identifying patients suitable for referral to tertiary centers with expertise in severe endometriosis cases, and providing comprehensive information about surgical options. Recent advancements include the introduction of scores, such as the dPEI MRI score, which is currently receiving excellent feedback from the clinical community, confirming the importance of a universal language.