Scar endometriosis is a rare form of endometriosis characterized by the presence of endometrial tissue in the abdominal wall following a cesarean delivery. We present a case report of a 38-year-old female with scar endometriosis and provide a comprehensive review of the literature on its clinical management. The patient presented with intermittent pain and swelling at the site of her previous cesarean section scar. Imaging studies revealed a nodular lesion with characteristic features of scar endometriosis. Fine needle aspiration cytology confirmed the diagnosis, ruling out malignancy. The patient underwent wide surgical resection of the mass, resulting in the resolution of symptoms and no recurrence during follow-up. Our case highlights the diagnostic challenge of scar endometriosis, which can mimic carcinoma, and emphasizes the importance of a multidisciplinary approach involving clinical evaluation, imaging, and histopathological examination for accurate diagnosis and optimal management of this condition.