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Abdominal wall endometriosis is a very rare disease that usually develops in previous scar from caesarean section normally confined in subcutaneous fatty tissue. Intramuscular abdominal wall endometriosis involves rectus sheath or muscle. In this case abdominal wall endometriosis was intramuscular or musculoperitoneal and “away from previous scar” which created a diagnostic dilemma for surgeon both clinically and radiologically. Fine Needle Aspiration Cytology was not much useful in this case. Due to this diagnostic dilemma, surgeon performed wide surgical excision in this case.