Background. Endometriosis is one of the most common gynecological diseases and is associated with infertility, chronic pelvic pain, and other symptoms leading to impaired reproductive function and reduced quality of life in women. Analysis of trends in registered incidence and prevalence among the female population allows assessment of detection patterns across different age groups and territorial distribution of the disease, providing a basis for developing and implementing measures aimed at improving accessibility and quality of medical care. Purpose. To study long-term trends in registered prevalence and incidence of endometriosis among the female population of the Russian Federation from 2018 to 2024. Materials and Methods. Data from Federal Statistical Reporting Form No. 12 on registered cases of endometriosis among the female population of the Russian Federation for 2018–2024 were analyzed at the national level as well as across federal districts and constituent entities of the Russian Federation. Trends were assessed in the following age groups: adolescent girls aged 15–17 years, women aged 18 years and older, and women older than working age. Results. In 2024, the prevalence of endometriosis among women aged 18 years and older amounted to 636.0 per 100,000 corresponding population, representing a 22.6% increase compared with 2018; incidence reached 164.0 per 100,000 (+7.5%). The highest prevalence rates were observed in the Central, Siberian, and Far Eastern Federal Districts, while among individual regions the highest rates were recorded in the Nenets Autonomous Okrug and the Oryol and Tver Regions. The highest incidence rates were reported in the Siberian, North Caucasian, and Far Eastern Federal Districts, as well as in the Tver, Oryol, and Sakhalin Regions. Among adolescent girls aged 15–17 years, prevalence and incidence in 2024 amounted to 14.9 and 6.1 per 100,000 population, respectively, which is 10.9% and 18.7% lower than in 2018; the highest rates were registered in the North Caucasian, Southern, and Volga Federal Districts. Among women older than working age, prevalence and incidence in 2024 amounted to 50.2 and 6.4 per 100,000 population, respectively, representing decreases of 32.1% and 57.1% compared with 2018. Most federal districts demonstrated decreasing trends, except for the North Caucasian Federal District, where an increase was observed. Conclusions. The increase in prevalence of endometriosis among women aged 18 years and older may reflect both accumulation of chronic and recurrent cases and improved disease detection. Fluctuations in incidence and prevalence trends among adolescents aged 15–17 years require further epidemiological analysis. Against the background of active detection and treatment of endometriosis among women of reproductive age, both prevalence and incidence decline among women older than working age.