This discussion of endometriosis associated with pregnancy is restricted to external endometriosis. The exclusion of internal endometriosis is based on concurrence in the belief that the two diseases are etiologically separate and their relationship to pregnancy distinctly different. The literature to date suggests that endometriosis associated with pregnancy is infrequent. Articles dealing with the subject specifically are few. The already voluminous and rapidly increasing literature regarding endometriosis deals with etiology, pathogenesis, and management, medical or surgical. Discussions pertinent to endometriosis associated with pregnancy are involved with review of literature with additions of case reports. Scott 1 did service in this respect and subsequently scattered case reports have been recorded. The initial appearance of this subject in a standard textbook was made in 1950. 2 It has been stated that "combining a discussion of endometriosis and pregnancy is in some measure a paradox." This is further supported by the belief that the lesions are associated with infertility, relative and absolute. There are many comments in the abstract bearing upon the effect of the one on the other. These opinions vary in extremes. Goodall, 3 in 1943, stated that in his experience with hundreds of cases of endometriosis he had never seen pregnancy and, further, that it was fortunate the two conditions never coexist. Meigs, 4 originally in 1922, and two years later Sampson, 5 put forth the supposition that the lesion might be favorably influenced by pregnancy. Beecham, 6 in 1949, said, "Nature (since the beginning of time) has employed an efficient prophylactic and curative measure for endometriosis, i.e., pregnancy." In the same discussion he said, "Pregnancy must be considered the ultimate in endocrine therapy, but why the physiologic amenorrhea causes the endometrial implants to regress, we do not know." Randall, 7 in the same year, discussing therapeutic effects of estrogens, said, "Foci of endometriosis seem to improve remarkably during pregnancy." These authors did not offer substantiative evidence for these statements, yet I am sure it must be available. The recommendation to the endometriosis victim to conceive is repeatedly observed in the literature, but whether for its therapeutic effect or in anticipation of associated infertility, is not too clear. This latter concept was productive of cases for this report.