How accurate is ultrasound for detecting endometriosis?

Ultrasound is very good at identifying ovarian endometriomas (endometriosis cysts on the ovaries) and can also detect many cases of deep endometriosis when it’s performed by a sonographer or physician with specific endometriosis imaging expertise. It’s especially helpful for mapping disease that involves structures like the bowel, the area behind the uterus, or the bladder, where characteristic findings may be visible on a targeted exam.

At the same time, ultrasound rarely shows superficial peritoneal endometriosis, so a “normal” scan does not rule out endometriosis or explain away symptoms. In our practice, we use imaging as one piece of the puzzle alongside your history and exam, and sometimes additional imaging like MRI when it could change surgical planning. If your symptoms strongly suggest endometriosis despite normal imaging, our team can help you understand what your results do—and don’t—mean and discuss next steps.