Uterosacral Endometriosis is very commonly encountered not just in patients with endometriosis per se, but also seen in patients with Adenomyosis & Uterine Leiomyomas. Very commonly, the Ureter especially the left side is involved as well. This video aims to highlight the cardinal principles of MIS management and laparoscopic excision of endometriotic lesions on the uterosacral ligaments. The salient points & laparoscopic technique is being highlighted in this video as well.