Endometriosis is a chronic debilitating disease that occurs in 6- 10% of the female population and about 35-50% of women with pain, infertility or both and characterized by endometrial tissue outside the divided into pelvic and extrapelvic sites. The most common sites affected are ovaries, however it can occur in rare sites like gastrointestinal tract, pulmonary structures, diaphragm, umbilicus, urinary system, laparotomy and episiotomy scars, breasts, perineum, extremities and even in central nervous system. The clinicopathological spectrum of endometriosis with emphasis on occurrence at unusual sites were studied with total of 30 cases from different sites diagnosed as endometriosis by FNAC (4 cases) and histopathology in all cases over a period of 17 years in a tertiary care hospital. The most common site located is ovary in 23 cases (76.6%) followed by abdominal wall in four cases (13.3%). The uncommon extrapelvic locations , include each in vulva (3.33%), perianal (3.33%), and bladder (3.33%). Clinical presentation in different location of endometriosis varies. Malignant transformation is very rare and may
occur in less than 1% of women, the most common site being ovary. Regarding pathogenesis, several theories are suggested. Follow up varied from 1-2 years. The typical presentation and local findings allows to make a correct diagnosis in
clinically suspicious endometriosis. Proper caution must be taken during lower abdomen surgical procedures. Complication like bleeding from cyst, bowel obstruction in intestinal, reduced fertility etc, may be circumvented, if early diagnosis and treatment is instituted.

Keywords: Endometriosis; Chocolate Cyst; Scar Endometriosis; Extra Pelvic Endometriosis.