Bladder endometriosis (BE), a rare form of deep infiltrating endometriosis, affects about 7% of endometriosis cases, often presenting with suprapubic pain or dysuria, worsened during menstruation. This case highlights an unusual BE presentation mimicking a bladder mass.

A 38-year-old woman from Jodhpur, India, with known pelvic endometriosis, reported two years of cyclical suprapubic pain during micturition. Imaging showed bladder wall thickening, and cystoscopy revealed a 2 × 2 cm bluish mass on the posterolateral wall, initially suspected as a tumor. Transurethral resection of bladder tumor (TURBT) under general anesthesia

Postoperative recovery was uneventful, and she was discharged on day 4. Histopathology confirmed BE and ER-α positivity, with no evidence of malignancy.

BE can mimic bladder tumors, necessitating a high index of suspicion in women with endometriosis and cyclical urinary symptoms. Multidisciplinary evaluation with cystoscopy and histopathology is key to accurate diagnosis, while TURBT offers effective management with good outcomes.