Atypical polypoid adenomyoma (APAM) is a rare polypoidal benign tumor of uterus, which usually presents with irregular vaginal bleeding in women of reproductive age. It has the potential of malignant transformation but does not metastasise. It may coexist with endometrial hyperplasia and adenocarcinoma; and so, is usually misdiagnosed. It is composed of atypical endometrial glands along with bundles of smooth muscle fibres. It has a high incidence of recurrence. We describe a case of APAM, which was managed at a tertiary care hospital. A 25-year woman with irregular vaginal bleeding and abdominal mass had total abdominal hysterectomy (TAH) on suspicion of endometrial sarcoma. Histopathology specimen revealed APAM. On follow-up so far, she is in stable condition and asymptomatic. Key Words: Atypical polypoid adenomyosis, Adenosarcoma, Endometrial carcinoma.