Scar endometriosis can be a great mimic of common surgical and gynaecological conditions in reproductive age females. The correct preoperative diagnosis is only achieved in a relatively low number of patients (20-50%). This uncommon condition presents diagnostic challenges and requires surgical excision in most cases. Ultrasound represents a useful tool to triage and direct management as well as further investigations. We present a case of scar endometriosis in a young female with a previous history of caesarean section.