Can scar tissue look like endometriosis on ultrasound or MRI?

Yes. Scar tissue (adhesions or postoperative scarring) can sometimes resemble endometriosis on imaging, and endometriosis itself can also create fibrosis that looks “scar-like.” Ultrasound and MRI can be very helpful when they’re expertly performed and interpreted, but the findings can still land in a gray zone—especially when inflammation, prior surgery, or distorted anatomy is involved.

This is also why we don’t diagnose (or rule out) endometriosis based on imaging alone. Our approach is to pair imaging with your full symptom story, flare pattern, and exam findings, and to actively consider look-alike or coexisting conditions (like adenomyosis, pelvic floor dysfunction, hernias, or vascular causes) that can mimic endometriosis pain.

When the distinction truly matters for your treatment plan, the most definitive answer usually comes from surgery with histopathology of excised tissue. If you’ve been told imaging “looks like endo” (or “just scar tissue”) but your symptoms don’t add up, reach out—our team can help you sort out what’s most likely and what next steps make sense.