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Scar endometriosis is a rare form of extra-pelvic endometriosis that can occur after surgery involving the uterus. Direct mechanical implantation seems to be the most conceivable theory for scar endometriosis. Patient usually presents with lump and pain at surgical site. Often the diagnosis of endometriosis is not suggested until histology has been performed. We hereby present a case of scar endometriosis diagnosed preoperatively by fine-needle aspiration cytology. Scar endometriosis is a rare cause of painful scar; therefore, high index of suspicion is suggested in clinching the diagnosis. The recommended treatment is wide surgical excision with at least 1 cm margin on all sides. While performing lower segment caesarean section some preventive measures should be taken to prevent its occurrence. Histopathological examination is mandatory, as there is rare possibility of malignant transformation. Follow-up is advisable to diagnose recurrence.vv