Background: Endometriosis significantly impairs female fertility, necessitating effective surgical interventions to enhance reproductive outcomes.Objective: This prospective study aims to evaluate post-surgical fertility outcomes in women undergoing endometriosis-related gynecologic procedures at Barasat Government Medical College, Barasat, North 24 Pgs, Kolkata.Methods: Over a one-year period, from January 2023 to December 2023, 100 women diagnosed with endometriosis underwent gynecologic surgeries, including laparoscopic excision, adhesiolysis, and ovarian cystectomy. Patients were followed for 12 months post-surgery to assess fertility outcomes. Data collected included spontaneous conception rates, success rates of assisted reproductive technologies (ART) such as in vitro fertilization (IVF), and changes in ovarian reserve markers (Anti-Müllerian Hormone [AMH] levels). Statistical analyses were performed to compare outcomes based on disease severity, surgical technique, and patient-specific factors.Results: Among the 100 patients, 60 achieved spontaneous conception within one-year post-surgery (60%), while 30 required ART, achieving a 70% success rate (21/30). Stratifying by disease severity, 75% of patients with minimal to mild endometriosis (stage I-II, n=60) conceived spontaneously compared to 45% in those with advanced disease (stage III-IV, n=40), with the difference being statistically significant (p = 0.02). The average AMH levels increased from 2.0 ± 0.5 ng/mL pre-surgery to 2.4 ± 0.6 ng/mL post-surgery, representing a 20% improvement (p < 0.05). Complications included postoperative adhesions in 5 patients (5%) and a decline in ovarian reserve in 3 patients (3%). Overall, 85 out of 100 patients (85%) reported improved fertility outcomes post-surgery. Additionally, personalized surgical approaches yielded a higher pregnancy rate of 80% compared to 65% with standard techniques (p = 0.03).Conclusions: Surgical intervention at Barasat Government Medical College significantly enhances fertility outcomes in women with endometriosis, particularly in early-stage disease. Personalized surgical approaches optimize reproductive success, underscoring the need for individualized treatment plans.