Study Objective To demonstrate a novel multi-disciplinary decision tree for workup of colorectal endometriosis and subsequent collaborative surgery. Design Case Report. Setting Community teaching hospital. Collaborative robotic surgical team including a minimally invasive gynecologic surgeon and colorectal surgeon utilizing the Da Vinci Xi platform. Patients or Participants 41-year-old Gravida 0 with morbid obesity, history of stage IV endometriosis presenting with worsening dysmenorrhea, heavy menstrual bleeding, pelvic pain and cyclic rectal bleeding. Interventions Utilization of a novel multi-disciplinary decision tree for workup and subsequent surgical management of colorectal endometriosis. Surgery performed was a robotic-assisted low anterior bowel resection with primary colorectal anastomosis and a total laparoscopic hysterectomy, right salpingectomy, lysis of adhesions and excision of endometriosis. Measurements and Main Results Complete excision of endometriosis and adenomyosis, including colorectal disease. Improvement of patient's pelvic pain and resolution of her dysmenorrhea, heavy menstrual bleeding and rectal bleeding. Conclusion Utilization of our novel multi-disciplinary decision tree can standardize and optimize care for cases of complex colorectal endometriosis.