Pelvic venous disorders (PeVD) represent a spectrum of pathologies arising from ovarian, internal iliac, and pelvic plexus venous reflux or obstruction. These conditions are increasingly recognised as causes of chronic pelvic pain, dyspareunia, and lower limb varicosities. Historically termed “pelvic congestion syndrome,” the condition has been redefined with the advent of the Society for Vascular Surgery (SVS) and American Venous Forum (AVF) classification systems, including the Symptoms-Varices-Pathophysiology (SVP) framework. Management is multimodal and tailored to the pattern of disease. First-line therapy involves minimally invasive endovascular embolisation of refluxing ovarian or internal iliac tributaries using coils, plugs, or liquid embolics such as Onyx or sclerosants. Comprehensive treatment often requires addressing the pelvic venous reservoir rather than only ovarian trunks to prevent recurrence. In selected patients with obstructive lesions iliac stenting may be indicated. Surgical options are now rarely required. PeVD is a common but underdiagnosed cause of chronic pelvic pain. Adoption of the SVP classification has standardised diagnosis, while endovascular therapies have become the cornerstone of management. Ongoing research into long-term outcomes and optimal embolic strategies will continue to refine care for this challenging but treatable condition.