not-yet-known not-yet-known not-yet-known unknown 1 Introduction: Endometriosis is a medical condition where endometrial-like tissue grows outside the uterine cavity. Though different studies show different etiology, its growth is regulated by hormones and is associated with menstruation. In females, it is the most common cause of chronic pelvic pain. The estimated prevalence of it in women of reproductive age group is about 12%. And about 15-25% of it is found in women with infertility problems.(1) The most common sites of its involvement are ovaries, uterosacral ligaments, pouch of Douglas, rectosigmoid colon, bladder and distal ureter. The abdominal wall is the most frequent site of extra-pelvic endometriosis (4%) and is often linked to surgical scars from previous gynecologic procedures such as cesarean sections, hysterectomies, hysterectomies, tubal ligations, or myomectomies.(2) Though the abdominal wall is the most common site of extra-pelvic endometriosis, its occurrence in the anterior abdominal wall is rare. When it does occur, it presents as a palpable lesion associated with cyclical pain and a history of abdominal surgery, particularly cesarean section (CS).(3) Only around 0.03-0.4% of cesarean section surgeries develop the rare complication of surgical scar endometriosis. Because of its rare occurrence, there is a high rate of misdiagnosis, often being mistaken for hematomas, hernias, granulomas, abscesses, neuromas, or even neoplastic tissues. And a high level of clinical suspicion is required to diagnose iatrogenic scar endometriosis in women who present with abdominal pain and have a history of abdominal surgeries.(4) Here, we report a case of cesarean scar endometriosis in a 27-year-old woman presented with cyclical abdominal pain, occurring two years after a cesarean section adhering to SCARE guidelines 2020.(5) 1 Introduction: