We reported on a case of granulation tissue of large size in the vagina after Manchester operation. A 71-year-old patient was admitted with a tumor of 7 cm in diameter in the vagina. The patient had undergone Manchester operation a year before. Granulation of tissues in the vagina are an often complication after hysterectomy. Clinical symptoms are mucous or blood secretion and mild coital bleeding. In some cases it might also be asymptomatic. It was found that in more than 30% of women after hysterectomy there is granulation tissue in the vagina. It was observed that in more than 60% it is ≤5 mm in size and that it regresses more often than in cases where it is of >5 mm (72% and 33%, respectively). Granulation tissue of >10 mm is very rare. Double biopsies of the 7-centimeter tumor did not provide sufficient information on the tumor origin. There are different therapeutic options for granulation tissue depending on its size – from observation to laser and surgical treatment. In the presented case the only possible option was according to us cautious removal of the tumor from the anterior wall of the vagina to prevent bladder damage. Tumor excision was performed – immunohistochemical staining methods revealed granulation tissue.