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Primary fallopian tube carcinoma (PFTC) is a rare malignancy often misdiagnosed due to nonspecific presentations. Accurate preoperative diagnosis remains challenging, with laparoscopy serving as a critical tool for intraoperative evaluation. Aims & Objectives To highlight the role of diagnostic laparoscopy in identifying PFTC in a postmenopausal woman presenting with abnormal bleeding, emphasizing its significance in cases with inconclusive imaging and clinical findings to ensure timely and appropriate management. Material & Methods A 60-year-old postmenopausal woman presented with abnormal uterine bleeding for two months. Ultrasound showed a vascular adnexal lesion suspected to be a subserosal myoma or ovarian tumor. Diagnostic laparoscopy revealed a solid mass originating from the right fallopian tube with fimbrial adherence to the omentum. Intraoperative frozen biopsy suggested high-grade serous carcinoma. A complete staging laparotomy was performed, followed by adjuvant chemotherapy. Results Histopathology confirmed PFTC (FIGO stage III C). Imaging misclassified the lesion, underscoring diagnostic limitations. Laparoscopy provided a precise intraoperative assessment, enabling accurate diagnosis and appropriate surgical staging. The patient responded well to adjuvant chemotherapy, with favorable early outcomes. This case highlights the indispensable role of laparoscopy in detecting rare gynecological malignancies. Conclusions PFTC is a diagnostic challenge due to nonspecific presentations and imaging limitations. Diagnostic laparoscopy is pivotal for identifying and staging such malignancies, ensuring timely management. Incorporating laparoscopy into the diagnostic algorithm for suspected adnexal masses improves accuracy, surgical outcomes, and patient prognosis.