Abstract: Objective To study the clinical features, diagnosis, treatment and prognosis of pubescent endometriosis patients. Methods Clinical data about 41 pubescent endometriosis patients admitted to our hospital from 2008 to 2012 were retrospectively analyzed. Results Of the 41 pubescent endometriosis patients, 19.5% were complicated with genital tract malformation.The average time between the diagnosis of pubescent endometriosis and menophania was shorter and the r-AFS staging was earlier in the patients genital tract malformation than in those without genital tract malformation (P< 0.01, P< 0.05). Of the 41 patients who underwent laparoscopic ovarian cystectomy and lesion excision or orthomorphia surgery, 25 received gonadotropin-releasing hormone agonist therapy after operation. Thirty-six patients were followed up. The recurrence rate was lower in patients who received drug treatment than in those who underwent simple operation (P< 0.05). Conclusion The main clinical symptoms of pubescent endometriosis patients are dysmenorrheal, chronic pelvic pain, and acute abdominalgia. The age is younger and r-AFS staging is earlier in patients with genital tract malformation than in those without genital tract malformation. Operation is its main treatment modality and drug treatment can effectively prevent its recurrence.