Abstract:The objective of this study is to examine the level balance of serum and peritoneal fluid MMP-2 and TIMP-2 in patients with severe endometriosis. The method of this study was a cross sectional study with twenty patients were diagnosed as severe endometriosis based on laparoscopy and laparotomy with five controls. Serum samples were taken before surgery, peritoneal fluid samples were taken during surgery, and MMP-2 and TIMP-2 examination was conducted in the end of the study by using ELISA method. The mean level of serum, peritoneal fluid MMP-2 and TIMP-2 were compared by using unpaired t-test. Based on this study, we found that MMP-2 level of serum and peritoneal fluid was significantly different in the case compared to the control, 5.848±3.016 vs. 1.600±0.063 ng/mL and 1.977±1.883 vs. 0.573±0.084 ng/mL respectively. When TIMP-2 level of serum and peritoneal fluid compared to the control, the significant difference was only found in serum (p < 0.05), 0.853±0.343 vs. 0.637±0.116 ng/mL and 1.339±2.141 vs. 0.105±0.028 ng/mL respectively. This study showed that there was an increase of MMP-2 level of serum and peritoneal fluid and low level of serum and peritoneal TIMP-2 in severe endometriosis. Serum and peritoneal fluid MMP-2 as well as TIMP-2 in serum had a significant relationship with the incidence of severe endometriosis. Meanwhile, TIMP-2 in peritoneal fluid had no significant relationship with the incidence of severe endometriosis.