OBJECTIVES Endometriosis is a disease with social and economic impact. We analyses the clinical and pharmaco-economical efficacy of the treatment of genital endometriosis.  METHODS This open-label prospective comparative research was performed in 2012-2013 on Center of Endometriosis of Astana. Results of treatment taken from 180 female patients with endometriosis aged 19-35 years old were included into the study. All of them were divided on three groups depending on the methods of therapy.  1^st group have a endo-surgery treatment (60 patient), 2^nd group (60 patient) - only hormonal therapy (Dienogest 2 mg per day for 6 months) and 3^d group  - combined therapy (after endo-surgery taken the Dienogest 2 mg per day for 6 months). For the calculation of cost/effectiveness index we included all of the direct medical expenses. RESULTS In the first group efficacy index is 66,7%, in the second group – 70,0% and in the third group – 91,7%. Index cost/effectiveness for endo-surgery is 143 298 KT (1$=182KT), cost/effectiveness for hormonal therapy is 92 428 KT and cost/effectiveness for combined methods is 115 718 KT.  Surgical treatment has the low efficiency of the high costs compared with other therapies.  The indicator of cost/effectiveness of the combined therapy is higher than in the hormonal treatment: higher efficiency cost in additional costs. For the objectification of this fact calculated Incremental Index per patient: 186 500 - 107 833 / 92.0 - 70.0 = 182 KT. So, the increase of one percent of effectiveness combined therapy compare to hormonal therapy reflects additional cost, not more than 182 KT per patient.  CONCLUSIONS Hormonal therapy resulted as the cost-saving therapy of genital endometriosis in young women. The higher efficiency of treatment of endometriosis are needed additional expenses.