There are multiple causes of pelvic pain, and it is very important to acknowledge that in most women pelvic pain is not of gynecological origin. It is also important to remember that in most patients with pelvic pain there is more than one reason for pain and simply just treating endometriosis without addressing pelvic floor or bladder pain or associated emotional issues is not enough. History is by far the single most important part of the diagnostic process, with examination being less useful and radiological tests often not helpful at all. Three simple questions can probably diagnose most of the causes for pelvic pain: How did the pain start, what makes in better and what makes it worse? Patients whose pain began at menarche may have endometriosis, but cyclical pain does not always mean the diagnosis of endometriosis. Many pain symptoms may worsen during the menstrual period. Conversely, when pain begins after surgery or trauma to the pelvis it is almost certainly not endometriosis. Pain after delivery may be due to musculoskeletal issues (muscle spasm, nerve injury, incisional neuroma – episiotomy or laparotomy scar) but also result from congested pelvic veins. Pain that worsens with physical activity and improves with rest and use of a heating pad is almost always of musculoskeletal origin. Finally, pain with a full bladder may be consistent with interstitial cystitis/bladder pain syndrome but pain at the end of urination is often from spasm of pelvic floor muscles. Pain during intercourse is present in most of the conditions causing pelvic pain but in patients with pelvic floor muscle spasm this pain/pressure usually persists for hours to days after. Use of questionnaires such as the one developed by the International Pelvic Pain Society may be very useful to determine the cause of pain.