Objective. To define the most important factors and mechanisms of peritoneal adhesions formation to evaluate the methods of  prevention and treatment. Material and methods. The PubMed database was searched to identify studies about the role of inflammatory stress in pelvic peritoneal adhesions. Results. The literature data and own studies showed that pelvic peritoneum is involved in the development of inflammatory stress in the abdominal cavity with the formation of peritoneal adhesions on the basis of the different signal paths and multi-directional cascade reactions: angiogenic-inflammatory or inflammatory-angiogenic. It results in serological changes and clinical manifestations of the pathological process. Conclusion. The implemention of current data about inflammatory stress in clinical practice allows to increase the therapy efficacy and make it targeted.