Uterine sarcomas are heterogeneous group of malignancies both clinically as well as pathologically. Lieomyosarcoma contributes for majority of uterine sarcomas (30-40%) with the peak incidence in postmenopausal women (50-60 years). Endometrial Stromal Sarcoma accounts for 10% of uterine malignancies, generally an indolent disease with long natural history. It presents in relatively young age. ESS tumors have high incidence of oestrogen and progesterone receptor expression, and are hormonally responsive. We present a case of a endometrial stromal sarcoma in a 28 years old patient who presented with heavy menstrual bleeding and secondary subfertility. Ultrasound scan revealed a typical appearance of a leiomyoma. However, later diagnosed a ESS and had undergone surgical management by gynaecological oncosurgical team. Preoperative diagnosis of uterine sarcoma in a young patient is always a challenge. Surgery is the mainstay of treatment. However, due to high expression of hormone receptors peri-operative hormonal suppression plays a vital role in prevention of recurrence and treatment of advanced cancers.