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INTRODUCTION: Endometriosis is second most common benign gynecological condition, INCIDENCE: Scar endometriosis 0.3 to 1.0%, caesarian scar endometriosis 0.03% to 1.7%. PATHOGENESIS: Autologous transplantation or direct implantation of viable endometrial tissues that implant at open surgery wounds. OBJECTIVES: To present a rare case of caesarian scar endometriosis, to discuss the pathogenesis and symptomatology, to present the management condition. CASE REPORT: A 30 year lady G2P1L1 with 21 weeks 3days GA. She had previous LSCS in 2021 for Cephalopelvic disproportion. Post delivery after 3 months her menstruation resumed with normal flow but later small swelling at C-section scar developed gradually over a period, she had cyclical pain at scar site 3-4 days prior to menstrual cycle and subsided as menstruation stopped. Later she was presented OPD for 8 week of amenorrhea and UPT positive advised USG abdomen & pelvis diagnosed with 6 weeks 5 days Gestational age, with SCAR ENDOMETRIOSIS of size 1.54 X 1.95CM. Advised continued pregnancy with close follow-up. DISCUSSION : ENDOMETRIOSIS occurs when glans and stroma of uterus grows in an aberrant heterotopic location. The most common extra pelvic form of endometriosis is cutaneous endometriosis mainly in scars following obstetrics and gynecological surgeries, such as Pathogenesis can be through retrograde Menstruation, transplantation via lymphatics/vascular system, Hematogenous dissemination, familial and iatrogenic dissemination. Symptoms: cyclic pain in 80% and mass among 70% of cases. Ultrasound is the most accessible, reliable, and effective imaging in this case and In our case, it is through iatrogenic dissemination via Cesarean section that have caused the implantation of glans and stoma outside the uterus causing increasing severity of pain during menstruation. CONCLUSION:A thorough history and physical examination should always be performed in addition with help of imaging techniques and biopsies. Wide excision is the treatment of choice, HPE should be done to rule out rare possibilities of malignant transmission, follow up is recommended to diagnose recurrence.