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Malakoplakia is a rare chronic granulomatous disease. It was first reported in 1902 by Michaelis and Gutmann. It may involve any part of the body, most commonly affecting the urinary tract, mainly the urinary bladder. The involvement of uterus resulting in postmenopausal bleeding is extremely rare but not unusual. So, in the differential diagnosis of post-menopausal bleeding, this condition should be kept in mind which poses as a diagnostic enigma requiring a high degree of suspicion from the clinician, the radiologist and the pathologist. Due to paucity of data owing to the rarity of the condition, there are no treatment guidelines for this condition, leading to a therapeutic dilemma. We report herein an unusual case of malakoplakia of the uterus with actinomycoses co-infection in a 60-year-old lady with postmenopausal bleeding and an abdominopelvic lump mimicking malignancy.