Radiologic imaging plays an important role in the diagnosis of pelvic congestion syndrome in patients with chronic pelvic pain. Pelvic congestion syndrome is a diagnosis of exclusion and differential diagnosis includes endometriosis, pelvic inflammatory disease, and ovarian cysts. In this syndrome, ovarian and pelvic veins are dilated owing to incompetence and venous reflux or to reversed venous flow associated with renal vein or ovarian vein stenosis. Ovarian vein venography is the gold standard for the definite diagnosis, which is usually performed before treatment. In this review, radiologic findings of pelvic congestion syndrome are discussed with their advantages and limitations. Role of interventional radiology and other treatment options including medical and surgical treatments are reviewed.