Objective: Bowel is the most common extragenital manifestation of endometriosis. Clinical suspicion is of utmost importance for achieving its diagnosis. Management of this condition is however, always challenging to the gynaecologist.

Method: We report a case of bowel endometriosis in which patient presented with dyschezia and haematochezia prior to her menses for the past two years. 

Result: A 44-year-old Para 2, woman presented with worsening dysmenorrhea and dyspareunia. She also experience dyschezia and haematochezia prior to her menses for the past two years. Examination revealed a fixed retroverted uterus. Computed Tomography scan showed focal bowel thickening. She underwent colonoscopy examination and biopsy that revealed stromal endometriosis. She was subsequently treated with dienogest and became asymptomatic. 

Conclusion: Diagnosis and management of this debilitating illness was revisited and discussed.