Endometriosis is characterized by ectopic endometrial tissue, which responds to ovarian stimulation. Endometrioma is the term given to extra-pelvic endometriosis that forms a discrete mass surrounded by a connective tissue capsule. We present a retrospective review of five patients diagnosed with abdominal wall endometrioma in our institution within the last three years. We review symptoms, diagnostic methods, and surgical management, as well as current literature regarding this patient population.Endometrioma is an unusual disease process that must be included in the differential diagnosis of chronic abdominal pain associated with a mass in the incisional area of a patient with a previous Cesarean section. The development, cell biology, complex biochemical and endocrine features of its pathogenesis, and obvious intricate interaction with musculofascial elements relative to other abdominal wall layers are intriguing and merit further investigation.