Abstract: The pathogenesis of endometriosis-associated diseases is complex, posing significant challenges for clinical treatment. Recent studies have demonstrated that iron metabolism dysregulation within the lesional microenvironment can activate ferritinophagy, leading to the release of free iron and subsequently inducing iron-dependent ferroptosis, which collectively drives disease initiation and progression. Traditional Chinese medicine (TCM) has shown unique advantages in modulating iron metabolism-related pathways, with the capacity to bidirectionally regulate the ferroptosis sensitivity of lesional cells and improve the lesional microenvironment. This review outlines the molecular mechanisms by which iron metabolism dysregulation drives ferritinophagy-mediated ferroptosis and summarizes the research progress on TCM formulas and active compounds that target relevant pathways in the treatment of endometriosis-associated diseases, aiming to provide a novel theoretical basis and therapeutic strategies for the clinical management of these diseases.