Introduction. Desmoid fibroma is a rare mesenchymal tumour developing from differentiated fibroblasts and excessive amounts of collagen fibres. This paper presents a clinical case of removal of an anterior abdominal wall neoplasm — a rectus abdominis muscle desmoid tumour, with the following mesh implant reinforcement of the musculoaponeurotic layer.Materials and methods. A 35 year old female patient Ch. was referred to the surgery department of “V nadezhnykh rukakh” hospital in November 2019, with complaints of a neoplasm in the anterior abdominal wall that was causing pain when touched, and dysuria. The patient’s clinical diagnosis was recorded as a neoplasm of the anterior abdominal wall.Results and discussion. The patient underwent further examination and scheduled surgery. The neoplasm was removed completely leaving the surrounding healthy tissues, the anterior abdominal wall was reinforced with a mesh implant. The pathology results matched a rectus abdominis muscle desmoid tumour. Literature offers very little information on anterior abdominal wall neoplasms or procedures for their removal with simultaneous plastic mesh implantation. Cases such as this require further study.Conclusion. A desmoid tumour of the rectus abdominis muscle can be radically removed; the procedure can be combined with the anterior abdominal wall plastic surgery with a mesh implant, making it possible to achieve a pronounced cosmetic effect regardless of the extensive surgical injury.