Fertility preservation techniques, such as cryopreservation of ovarian tissue, embryos, and oocytes, offer hope for future reproduction to individuals facing conditions like cancer or severe haematologic disorders. While the scientific evidence supporting fertility preservation is limited, it shows promise, and there is a growing trend among fertility experts to extend its application to patients with benign conditions that can cause fertility issues, such as endometriosis. Some forms of endometriosis may have a negative impact on fertility, affecting the ovarian reserve, oocyte quality, and the tubo-ovarian interface. Evaluating fertility preservation in endometriosis patients reveals several key considerations. The diverse nature of endometriosis calls for tailored approaches and distinguishing between the disease and treatment effects on ovarian reserve is crucial. Fertility preservation in endometriosis is complex, demanding consideration of disease variability, treatment effects, accurate assessment, and a clear distinction between ovarian reserve and conception ability. A personalised approach is essential for optimal outcomes in this field.