AIM: To rapidly evaluate the effectiveness, safety and economy of dienogest in the treatment of endometriosis so as to provide evidence-based reference for clinical drug selection and decision. METHODS: Retrieved from PubMed, Embase, Cochrane Library, CNKI, SinoMed, Wanfang and health technology assessment (HTA) organization websites, HTA report, systematic review/Meta-analysis and pharmacoeconomic study were included during the inception to Sep 2023. Data extraction and quality evaluation were carried out for the literature that met the inclusion and exclusion criteria, and the research results were summarized and analyzed qualitatively. RESULTS: Nine systematic review/Meta-analyses, and 2 pharmacoeconomic studies were included. The quality of Meta-analysis literatures was low, and the quality of economic research was good. In terms of effectiveness, compared with no treatment, dienogest can significantly reduce postoperative recurrence rate, VAS score, and improve pregnancy rate and effective rate; Dienogest has similar therapeutic effects in terms of recurrence rate as GnRHa and COC; With regard to recurrence rate and pregnancy rate, dienogest is superior to danazol, gestrinone, and mifepristone. In terms of safety, compared with placebo, the incidence of vaginal bleeding and headache was significantly increased with dienogest, and there was no difference in bone loss; The incidence of vaginal bleeding caused by dienogest was significantly higher than that of GnRHa, but the incidence of hot flashes and bone loss was lower. In terms of economy, dienogest has a more cost-effective advantage comparing with GnRHa, but does not have economic benefits comparing with COC. CONCLUSION: Dienogest has good effectiveness and safety in the treatment of endometriosis, and economically superior to GnRHa, but inferior to COC.