Background: Invasive mole is a subtype of gestational trophoblastic disease (GTD) that usually develops from malignant transformation of trophoblastic tissue after evacuation of the mole. Invasive mole occurs mainly in women of childbearing age, whereas it is extremely rare in postmenopausal women. Observation: This is a 42-year-old cholecystectomized G3P2 patient who was referred for suspected GTD and whose pelvic echo and abdominal-pelvic CT scan revealed a hypervascularized image filling the uterine cavity, invading the myometrium to the serosa without invasion. The patient underwent total interannexal hysterectomy and chemotherapy with satisfactory clinical and biological follow up. Conclusion: Our case highlights the difficulties of diagnosing invasive moles in the absence of a significant history of gestational trophoblastic disease. This study reviews the diagnostic methods, histological features and therapeutic recommendations.