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Endometriosis is a painful chronic disorder in premenopausal period that causes severe pelvic pain. It could be problematic for both the patient and physician since routine analgesic drugs may not resolve the symptoms. Therefore, various destructive surgical treatments are used in these patients and presacral neurectomy is one of the best and most recommended surgical methods. This paper reports pre sacral neurectomy operation that was performed in Sari Imam Khomeini Hospital for the first time on a 31-year-old woman suffering from severe mid pelvic pain. She was resistant to treatment but favorable results were observed after the operation.