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Introduction: Endometriosis is a common benign gynaecological disorder characterised by the presence of ectopic endometrial tissue Aims and objectives: To preserve fertility and prevent disease progression Materials and methods: 32yrs old p1l1 with 1 previous lscs patient was admitted with chief complaint of severe cyclical pain abdomen since 2yrs. P/a findings showed 3*2 cms thickened scar. HPE of scar tissue biopsy showed endometrial hyperplasia without atypia diagnosed 2 yrs back .She took Inj. Leuprolide 3.75mg IM depot for 3months. patient was taken up for laparotomy and partial cystectomy, later she was kept on GnRH agonists post operatively. Results : MRI - scar endometriosis of 40*28*33mm invading the anterior bladder wall Scar endometrial tissue extending from rectus sheath to anterior abdominal wall-excised. Endometrial aspirate - endometrial hyperplasia whithout atypia Conclusion: treatment of bladder endometriosis requires a combined surgical team involving a gynaecologist and urologist for best possible result. Discussion: scar endometriosis is a rare form of endometriosis where endometrial tissue grows in a surgical scar typically after a cesarean section, hysterectomy,or other abdominal surgery.