Aggressive angiomyxoma is a rare mesenchymal tumor which affects mainly the soft tissues of the perineum and pelvis in young women. It has been diagnostically confused with benign soft tissue tumor which has a somewhat different clinical course and therapy. The tumor is characterized by its locally infiltrative behavior. The high recurrence rate has been attributed to incomplete surgical excision. Correct preoperative diagnosis and assessment of simultaneous perineum and pelvic involvement indicate a surgical approach to achieve wide, tumor-free margin. Recently we experienced a case of aggressive angiomyxoma arising in the posterior vagina wall after menopause, so we report this case with a brief review of literature.