Endosalpingiosis is a benign condition with unclear pathogenesis and clinical significance and is defined as the presence of ectopic fallopian tube-like epithelium. It can be found in multiple locations, most commonly in the pelvic peritoneum covering the ovaries, uterus, and fallopian tubes, and less commonly found in the lymph nodes, omentum, appendix, cervix, vulva, or vagina.It is difficult to distinguish from endometriosis by gross appearance or localization, and theories propose that tissues of the secondary Mullerian system may undergo a metaplastic transformation, for example, from endosalpingiosis to endometriosis, which contributes to the debated association of endosalpingiosis with chronic pelvic pain. Additionally, there is evidence demonstrating a close association with reproductive tract neoplasms.We report the clinical course, diagnosis including pathology, follow-up, and the treatment plan of vaginal endosalpingiosis in a 34-year-old woman presenting with a chronic painful right-sided vaginal mucosal ulceration, dyspareunia, and foul-smelling vaginal discharge. To our knowledge, this is the second reported case of vaginal endosalpingiosis and the first case with this presentation.