Endometriosis is common in clinical practice. Usually patients  present with abdominal pain or infertility. Endometriosis is not visible on ultrasound unless chocolate cyst are seen or indirect signs. Indirect ones are related to adhesions  in longstanding endometriosis. It can cause limited mobility of the uterus , adenxa ,irregular outline of ovaries from adhesions ,limited mobility of the intestine related with adherent loops and adherent adenxa. Sometimes, adhesions can cause peritoneal pockets .These pockets can be or cannot be absorbed based on the integrity of the relate peritoneum even if hormonal suppression is used . Usually, if persist, we can aspirate the fluid for relief and cytology or we can proceed with laparoscopy for dissection of related-adhesions . It can recur in both  techniques but slower and at a later time in laparoscopy . We are reporting a case here of a 30 years old sexually inactive lady who has 2 children delivered by cesarean section. She presented with a lower abdominal pain for years and she is on combined pills for a year . Ultraosund is showing an irregular outline of a normal sized ovaries adherent to the surrounding along with an irregular encysted turbid fluid collection . Pregnancy test was negative. The fluid was negative on cytology . Laparoscopy revealed encysted serosanguinous fluid that was deer-fed and drained for cytology . There was extensive superficial Peritoneum red spots through the wall of the cyst characteristic of endometriosis. (Figure 1) (1)