Ultrasound (US) represents the first-line imaging tool in patients with symptoms and signs of endometriosis. In advanced centers, sensitivity and specificity of US for deep infiltrating endometriosis (DIE), such as the sensitivity and specificity of magnetic resonance imaging (MRI), may exceed 80 – 90%, making these techniques highly useful alternatives to laparoscopy. The modified #Enzian classification of endometriosis (2021) is a valid and suitable tool which can be used for non-invasive and surgical procedures. This presentation promotes the practice of standardized, comprehensive and systematic US evaluation and reporting of endometriosis in pelvic structures, in correlation with the #Enzian classification. The ISGE 2021 recommendations for reporting findings obtained by dynamic US assessment is also presented.