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Introduction Primary Fallopian tube carcinoma(PFTC) is a rare gynecological malignancy that accounts for 0.14-1.8% of genital malignancies. The most common age of occurrence is between 40 and 65 years. Fallopian tube is a mullerian derivative but its malignancy closely resembles ovarian carcinoma. The diagnosis of PFTC is rarely considered pre-operatively and is usually first diagnosed by the pathologist. The earlier diagnosis of PFTC leads to an apparent better survival compared to ovarian carcinoma. Case report 53 year old parous lady with complaint of irregular bleeding per vagina for past 6 months. On evaluation- USG showed an elongated cystic lesion of size 6.8*2cm in the right adnexa, probably hydrosalpinx with particles and multiple polypoid solid hyper echoic areas suggesting malignancy. Her MRI showed complex cystic lesion in the right adnexa with solid papillary projections - O-RADS 4. Her CEA and CA 125 levels were normal. She underwent staging laparotomy. Intra Operatively right hydrosalpinx measuring 8x3x3cm with small projections near fimbrial end, blackish in color sent for Frozen section and came as High grade epithelial Carcinoma of Fallopian tube. total abdominal hysterectomy with bilateral salpingo-oophorectomy with Bilateral pelvic lymph node dissection and Infra colic omentectomy done. Final histopathology report came as High grade epithelial Carcinoma of Fallopian tube. Patient is plan for adjuvant chemotherapy. Conclusion Until more extensive clinical research has been performed, surgical staging/management and the use of chemotherapy follow the concepts used in epithelial ovarian cancer. Earlier diagnosis of primary Fallopian tube cancer helps us to ensure proper treatment strategy and enhance survival rates.