Uterine anomalies are congenital malformations arising due to embryological mal-development of mullerian ducts. The European society of Human Reproduction and Embryology (ESHRE) classifies these anomalies into 6 classes. Hemi-uterus is one such class of formation defect of mullerian duct with unilateral uterine development; the contralateral part could be either incompletely formed or absent. In a rare form of ectopic pregnancy, implantation can occur in the cavity of a rudimentary horn of the hemi-uterus. Authors report a case of 22-year G2P1L1 with 12 weeks gestation who presented with acute abdomen. Ultrasound showed hemoperitoneum with suspicion of ectopic pregnancy. Laparotomy confirmed the diagnosis of ruptured right rudimentary horn with fetus and placenta in the peritoneal cavity. Immediate laparotomy and excision of the horn with transfusion of blood and blood products saved the patient in the nick of time.
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