Endometriosis is defined as the presence of functioning endometrial tissue outside the uterinecavity, and the standard treatment is extensive surgical excision. Cesarean scar endometriosisis a type of cutaneous endometriosis arising on or near a Cesarean section scar. A 44-year-oldwoman presented with a 9×6 cm sized dark-brown, stony-hard, irregular, lower abdominalmass of four years duration. The patient had a history of two Cesarean deliveries, 14 and16 years ago. Suspecting endometriosis, we excised the tumor conservatively rather thanextensively to prevent incisional hernia considering the benign nature of the tumor andthe low possibility of recurrence because the patient’s age was near menopause, alongwith simultaneous bilateral salpingo-oophorectomy that was performed in this case. Onreconstruction, mini-abdominoplasty was adopted to avoid possible wound complicationsand cosmetic deformities. The patient was satisfied with the cosmetic results, and neitherrecurrence nor functional problems occurred during the 1-year follow-up period. Plasticsurgeons should keep in mind the possibility of cutaneous endometriosis in an abdominalmass of a female of reproductive age with a previous history of pelvic or intra-abdominalsurgery. An optimal result from oncological, functional, and cosmetic standpoints can beachieved with conservative excision followed by mini-abdominoplasty of extensive Cesareanscar endometriosis.