Scar endometriosis is a rare event which usually develops after pelvic operations involving the uterus and fallopian tubes. Its diagnosis can sometimes be difficult and may be confused with various other surgical conditions. We present here a case of abdominal wall scar endometriosis in a woman who has undergone cesarean delivery four years prior to her current presentation. The epidemiology, pathogenesis, clinical features, diagnosis, treatment and methods of prevention of this condition will be discussed in brief. This is an interesting case of surgical scar endometriosis and to the best of our knowledge this is the first case report in Ethiopia.