Abstract : Endometriosis is defined as the presence of endometrium-like tissue (glands and stroma) outside the lining of uterine cavity, which induces a chronic inflammatory reaction, scar tissue, and adhesions that may distort a woman’s pelvic anatomy [1]. The associated symptoms can impact the patient’s general physical, mental, and social well-being. The present study was undertaken to compare efficacy and side effects of Dienogest and ethinyl estradiol combination with Depot Medroxy Progesterone acetate in the treatment of endometriosis. A single centred, institution based study were carried out from March 2020 to February 2021 at the department of Obstetrics and Gynaecology in NRS Medical College and Hospital after obtaining ethical clearance. Among 72 women 15-45 years of age with pelvic endometriosis were included in this study. Study conducted from March 2020 to February 2021. 72 patients were involved in this study. The data was tabulated in Microsoft Excel software and analysed with SPSS V.24 software. The mean age in group 1 is 30.9 and mean age in group 2 is 29.8 years. In group 1, 63.9% had symptoms for 2 to 5 years and in group 2, 44.4 % had symptoms for 2 to 5 years. In group 1, 33.3% patient showed endometrioma in TVS where in group 2, 22.2% patient showed endometrioma in TVS. Treatment was acceptable to 61%patients in group 1 and treatment was acceptable 16.7% patients in group 2. Treatment was more acceptable in dienogest and ethinyl estradiol group. Ethinyl estradiol and Dienogest is a safe and effective drug for off label use in pain management of pelvic endometriosis. However, further studies in larger population with conventional Combined OCP s as control are needed.