<p>Background: Endometriosis is a prevalent condition among women, often leading to infertility. Laparoscopic surgery is widely employed as a therapeutic intervention for endometriosis. This study investigated the prognostic factors influencing the outcome of laparoscopic surgery for endometriosis.&nbsp;<br /> Methods: This cross-sectional study included 60 women with endometriosis referred for laparoscopic surgery at Amiralmomenin Hospital, Zabol, Iran, between 2022 and 2024. Pain intensity was measured using a visual analog scale (VAS). Statistical analyses were performed using SPSS version 26. Descriptive statistics summarized the data, while univariate analyses (t-tests and chi-square tests) assessed relationships between variables. Multivariate logistic regression identified independent predictors of pain reduction and pregnancy outcomes.<br /> Results: Patients with moderate endometriosis showed statistically significant pain reduction from 8.8 preoperatively to 1.8 at 9 months (p&lt;0.001) and 2.2 at 12 months post-surgery (p=0.003). Those with severe endometriosis had non-significant pain reduction (8 to 6 at 12 months, p=0.12). Both intrauterine (9 to 1.1 at 12 months, p&lt;0.001) and extrauterine involvement groups (8.6 to 3.3, p=0.004) demonstrated significant pain improvement, with no significant difference between the groups (p=0.779). Regarding fertility outcomes, treatment before the age of 30 significantly increased pregnancy likelihood (AOR=20.57, 95%CI 1.4-295.3), while other factors including BMI, CA125 levels, and parity showed no significant associations (all p&gt;0.05).<br /> Conclusion: These preliminary findings suggest that laparoscopic surgery may reduce pain in moderate endometriosis, while the age under 30 may be associated with improved pregnancy outcomes. However, given the study&rsquo;s limited sample size and wide confidence intervals, these results require validation in larger, multicenter cohorts.</p>