BACKGROUND:: Although most patients with a surgical stage I endometrial cancer have an excellent prognosis, some patients will experience a recurrence. Endometrial cancer typically recurs at the vaginal cuff or in the pelvis; however, it can recur distantly in the abdomen or lung. Although recurrences have been reported at laparoscopic trochar sites, it is unusual to have a recurrence in the abdominal incision after laparotomy. CASE:: A 51-year-old woman was diagnosed with stage Ib grade 2 adenocarcinoma of the endometrium and stage IV endometriosis. Six months after surgery, she presented with a mass in the lateral aspect of her Maylard incision. Computed tomography scans of the chest, abdomen, and pelvis showed no evidence of recurrent disease. The mass was resected and confirmed to be an adenocarcinoma similar to the endometrial primary. CONCLUSION:: This case is interesting because of the rapid recurrence of the endometrial primary at an unusual site - the abdominal incision. It illustrates the need to carefully evaluate all suspicious masses, even as early as 6 months after diagnosis and surgical staging. © 2004 by The American College of Obstetricians and Gynecologists.