ABSTRACT: INTRODUCTION: Granular cell tumours of the abdominal wall are extremely rare: less than 10 have been reported in the worldwide medical literature. We report this interesting case, review the relevant literature on this tumour and discuss surgical abdominal wall reconstruction options. CASE PRESENTATION: A 70 year old lady presented with a left abdominal mass. This was thought to be a soft tissue sarcoma on CT imaging prior to surgical excision. En-bloc surgical resection was performed. Surgical reconstruction of the abdominal wall defect was performed using Permacol(R) mesh. Histopathological examination of the surgical specimen showed it to be a granular cell tumour. CONCLUSION: Although rare, granular cell tumours can present as an abdominal wall mass. It is important that clinicians are aware of their existence. The closure of large defects, after surgical resection of abdominal wall tumours, is a surgical challenge. We used a new biosynthetic procine mesh (Permacol(R)) which appeared to work well in this situation.