Rhabdomyosarcoma (RMS) represents a rare subset of mesodermal malignancies characterized by skeletal muscle differentiation, exhibiting a notably low incidence among adults and demonstrating inferior prognosis compared to pediatric counterparts. The 5- and 10-year overall survival rates were determined to be 30% and 18%, respectively, with a median age of onset at 46.5 years and median overall survival duration of 2.3 years. Current challenges in RMS research encompass optimizing local control, managing systemic disease, refining risk stratification methods, and elucidating disease progression patterns. While aggressive therapeutic interventions remain imperative, novel and individualized treatment modalities are imperative to enhance long-term outcomes. This research reported an elderly female patient presenting persistent lower back pain, persisting over several months, despite seeking medical consultation from multiple sources. Subsequent diagnostic investigations confirmed the diagnosis of rhabdomyosarcoma, denoting the relatively rare etiology of said initial symptoms. Hence, it is imperative to reconsider many differential diagnoses in the case of ischialgia.