Aim — the objective of the present study was to evaluate the possibilities for the application of the endoscopic technologies for the purpose of the diagnostics and treatment of pelvic congestion syndrome (PCS). Material and methods. This retrospective study included 19 patients presenting with PCS and 10 women suffering from chronic pelvic pain (CPP) of unknown origin. The severity of CCP was estimated at 7.3±1.7 points. The transperitoneal resection of gonadal veins was performed in 14 patients and the retroperitoneal resection in 5 ones. To evaluate the diagnostic potential of videolaparoscopy, this technique was used to examine 10 patients with CCP of unexplained etiology as the primary method of examination. Results and discussion. The study has demonstrated that laparoscopy has low specificity for the diagnostics of PCS. The pathological reflux of the blood, which causes stagnation of blood in the veins of the small pelvis, was found only in 20% of the patients with the visually apparent laparoscopic expansion of the intrapelvic veins. When carrying out the transperitoneal resection of gonadal veins, it is necessary to apply carboxyperitoneum, to mobilize the descending and/or ascending parts of the colon which characterizes this intervention as more traumatic than the use of the retroperitoneal method. The patients who had undergone the retroperitoneal resection of gonadal veins, experienced a two-fold decrease in the operation time and pain intensity in the area of port setting; simultaneously, the duration of the postoperative stay in the hospital decreased to the same extent in the absence of complications. Regardless of the access to the gonadal veins employed in the present study, all the patients showed a significant reduction of CPP on day 7 after surgery (from 7.3±1.7 to 0.8±0.35 points). Conclusion. Both ultrasound and contrast-enhanced X-ray techniques should be used for the examination of the patients with pelvic congestion syndrome. Laparoscopy is equally advisable to use for the identification of a competitive pathology of the pelvic organs. The endoscopic resection of the gonadal veins serves as a highly efficient treatment for PCS. The retroperitoneal technique should be preferred over the transperitoneal resection bearing in mind its less traumatic character, and the absence of contact with the abdominal organs during the surgical intervention.