Objective To compare the efficacy and safety of dienogest (DNG) with depot leuprolide acetate (LA) in patients with recurrent pelvic pain following laparoscopic surgery for endometriosis. Design Prospective randomized trial. Setting Zagazig University hospitals, Egypt. Patients Two hundred and forty-two patients with recurrent pelvic pain following laparoscopic surgery for endometriosis. Intervention Dienogest (2 mg/day, orally) or depot LA (3.75 mg/4 weeks, intramuscularly) for 12 weeks. Main Outcome Measures A visual analogue scale was used to test the intensity of pain before and after the end of treatment. Results There was highly significant reduction in pelvic pain, back pain