Elastofibroma (EF) is a rare soft tissue tumor that typically occurs in the scapular region, with its occurrence in the rectum being extremely uncommon. In this report, we present a case of rectal EF in a 72-year-old female, which was definitively diagnosed through histopathology, immunohistochemistry, and special staining analyses. This case emphasizes the diagnostic challenges posed by rectal EF and underscores the necessity of histopathological and immunohistochemical assessment in distinguishing it from other spindle cell neoplasms, particularly when imaging findings are inconclusive.