Deep infiltrating endometriosis with colorectal involvement is a complex and challenging disease characterized by a long delay in diagnosis, debated preoperative work-up, and controversial and difficult surgical treatment. The literature is inconsistent regarding disease definition, clinical research criteria, and outcomes, which leads to inconclusive scientific debate characterized by misconceptions. Clinical consequences result from delayed diagnosis or misdiagnosis, unnecessary investigations, and incomplete and inadequate treatments that lead to psychological and physical sequelae for patients. The aim of this work was to review the literature to propose standardization for the clinical and instrumental diagnosis and surgical treatment of deep infiltrating endometriosis with bowel implants.