Оbjective — to study the effectiveness complex treatment of external genital endometriosis (surgical removal of heterotopies followed by administration of dienogest 2 mg per day from 3 to 24 months) in 82 patients. The level of pain on the visual analogue scale (VAS) and reproductive outcomes in 52 women who planned pregnancy were evaluated. Material and methods. Combined treatment of external genital endometriosis in 82 women, consisting of surgical treatment and subsequent appointment of dienogest 2 mg per day for 3—24 months, was conducted. The level of pain in VAS and reproductive outcomes in 52 women who planned pregnancy was study. Results. The initial assessment of pain was 8.2±1.3 points. After 3 months of treatment with dienogest, the assessment for VAS in 59 (86.7%) women was 2.4±0.3 points, and 9 (13.2%) women rated pain at 5.6±1.2 points. After 6 months of treatment, all the pain was zero. Spontaneous pregnancy occurred in 28 (53.8%) patients, of whom 24 (46.1%) women had timely deliveries, and in 4 (7.6%) pregnancy regressed in the first trimester. Another 6 (11.5%) patients had a pregnancy after in vitro fertilization and also ended timely deliveries. The total frequency of delivery was 34 (65.3%). Conclusion. The combination of surgical and medicine treatment (dienogest 2 mg per day) increases the likelihood of an onset and favorable outcome of pregnancy. Even a minimal course of treatment with dienogest improves pelvis pain syndrome in 86.7% of patients. Patients who are not interested in pregnancy can take dienogest for a long time to control the disease, prevent relapses and ensure a high quality of life.