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Data on both incidence of and time to recurrence of endometriosis was extracted. The incidence rate of endometriosis recurrence in patients treated with dienogest was 2 per 100 women over a mean follow-up of 29 months (95% CI 1.43 to 3.11) versus 29 per 100 women expectantly management, over a mean follow-up of 36 months (95% CI 25.66 to 31.74). Likelihood of recurrence was significantly reduced with post-operative dienogest (log odds -1.96, CI -2.53 to -1.38, p less then 0.001). Conclusion Patients receiving dienogest after conservative