Abstract: The microbiota is an important part of the human microenvironment and plays an important role in maintaining the normal function of the human body. The microecological flora changes with the changes of the internal and external environment of the human body. The imbalance of microflora may promote the occurrence and development of diseases including endometriosis through immune inflammatory response and metabolic disorders. Endometriosis (EMs) is a common estrogen-dependent disease in women, which is the growth of endometrial glands and stroma outside the uterine cavity. Existing studies have shown that the imbalance of intestinal and reproductive tract flora leads to local immune inflammatory response, which causes systemic immune inflammatory response through cytokines and metabolic pathways, and participates in the development of EMs. The role of microecological flora in the diagnosis and treatment of EMs is the goal of current research. This article reviews the research on the relationship between the imbalance of microecological flora and endometriosis.