OBJECTIVES: The drugs that are commonly used on endometriosis treatment have low efficiency and several side effects that prevent its long-term use. Dienogest is a progestin that acts on the development of endometrial tissue with minimum androgenic or central effects. The objective of this study is to review clinical studies that analyzed Dienogest efficacy on pain management, progression and recurrence of endometriosis, as well as its side effects associated with long-term use. METHODS: A systematic review of literature was conducted using MEDLINE?PUBMED data base, including studies that were published from 2009 to 2017 and that analyzed Dienogest effects on endometriosis. Studies that analyzed its clinical use on other diseases were excluded. RESULTS: The use of Dienogest was well-tolerated among patients and improved symptoms related to pain and sexual function, as well as patient's quality of life in all reviewed studies, when used isolated or compared to placebo or other drugs. Only four studies included in the review have analyzed recurrence or progression of endometriosis. These studies revealed reduction on recurrence rates of endometriomas that were surgically resected. Conversely, endometriomas or nodules that were not resected did not reduce in size with pharmacological treatment. Dienogest efficacy seems to increase cumulatively, which means that its long-term use may be benefic. However, some studies have identified a decrease on bone mineral density after months of use. CONCLUSIONS: Dienogest is a drug that has been studied over the last years, presenting good tolerability among patients, efficiency on reducing pain associated to endometriosis, but no efficiency on reducing size of nodules and endometriomas. Further studies are needed to better evaluate Dienogest action on reducing recurrence rates after surgical procedures, and to better understand its relation with decrease of bone mineral density as a potential side effect.