Endometriosis is defined as the ectopic growth of endometrium-like tissue. It brings pain and infertility to approximately 6–10% of women who are in reproductive age. The pathogenesis of endometriosis is still unclear, which also leads to underdiagnosis and delay in clinical diagnosis. Growing evidence suggests that endometriosis is associated with genetic, environmental, and epigenetic factors. It is valuable to discuss the potential impact of environmental factors in the development of endometriosis. Drug intervention can target the enzymes responsible for epigenetic alterations based on the controllability and reversibility of these features. Additionally, particular epigenetic biomarkers can be employed to diagnose illnesses and determine prognoses. This article discusses the relationship between endometriosis, environmental risk factors and epigenetics and looks forward to how epigenetic technology can be used in the diagnosis and treatment of endometriosis.