Pelvic Congestion Syndrome (PCS) is a chronic condition primarily affecting premenopausal, multiparous women, characterized by persistent pelvic pain and discomfort. This syndrome arises from venous insufficiency in the pelvic region, often due to incompetency in the internal iliac or ovarian veins, leading to pelvic venous dilation and varicose veins. Although the exact cause remains unclear, hormonal influences, venous valve insufficiency, and venous obstruction are believed to contribute to the development of PCS. In affected individuals, blood stasis and vein dilation can lead to pain through chemical mediators released during venous congestion. Epidemiological data indicate that around 30% of women presenting with chronic pelvic pain may have PCS, making it a significant contributor to chronic pelvic discomfort. This article reviews the etiology, pathophysiology, and epidemiology of PCS, offering insights into its diagnosis and potential treatment approaches.