Implantation endometriosis following caesarian hysterectomy is not an uncommon entity. Seeding of endometrium within the peritoneum and pelvic organs and the Pfannenstiel incision commonly occur. Post caesarean implantation endometriosis occurrence is determined by several factors. While endometriosis is a morbid disease, which causes pain, dysfunctional uterine bleeding and infertility, it is also a precancerous condition, and efforts should be made to avoid implantation endometriosis during uterine surgery. The object of this article is to present a 30 year old female with implantation endometriosis in a Pfannenstiel abdominal scar and to review the diagnostic facilities available and highlight the premalignant potential of endometriosis.