Endometriosis is a chronic disease that is thought to potentially begin at menarche and progress through a woman’s reproductive years. Adolescents with endometriosis present with dysmenorrhea and chronic pelvic pain. Endometriosis can be treated with medical and surgical management. Levonorgestrel intrauterine devices (LNG-IUD) are an effective option for medical management in adolescents. The primary objective of this study was to determine the rate of IUD insertion after laparoscopy for endometriosis in adolescents. The secondary objective was to compare the characteristics of the adolescent population with and without an IUD placed at the time of surgery. The medical records of 109 adolescent patients </= 21 years old were retrospectively reviewed for patient demographic information and surgical information. In our cohort, 36% of patients had an IUD placed at the time of laparoscopic surgery for endometriosis. Patients with an IUD placed at the time of surgery had a significantly higher BMI than patients who did not have an IUD placed (p = 0.004). The most reported symptoms were dysmenorrhea (77.1%) and chronic pelvic pain (94.5%). Patients with an IUD placed had higher rates of excision of endometriosis while patients who did not have an IUD placed had higher rates of ablation of endometriosis (p = 0.003, p = 0.05). Dysmenorrhea and pelvic pain are commonly reported by adolescent patients with endometriosis. LNG-IUDs are often placed at time of excision of endometriosis surgery for adolescents and further studies are warranted to see if they are effective in the long term postoperative medical management of adolescents who have completed surgery.