Endometriosis (Endometriosis, EMs) is a disease caused by abnormal colonization of the endometrial stroma or glands to sites other than the coated mucosa of the uterine cavity. Phospholipid inositol 3 kinase (phosphoinositide 3-kinase, PI3K)/protein kinase B (protein kinase B, Akt) signaling pathway is involved in the process of focal blood vessel formation, cell autophagic apoptosis, migration and invasion, and is one of the classic pathways regulating the pathological characteristics of EMs. The characteristics of multi-component, multi-target and multi-pathway of TCM have significant advantages in the treatment of EMs. Some TCM active components and TCM compounds can interfere with the PI3K/Akt signaling pathway, thus inhibiting the treatment of endometriotic tissues, reducing pain and alleviating fibrotic lesions. By explaining the connection between the key targets of PI3K/Akt signaling pathway and EMs, this paper summarizes and summarizes the research status of EMs by regulating PI3K/Akt signal pathway in home and abroad, aiming to provide a new perspective and idea for the use of traditional Chinese medicine and compound to treat EMs.