Introduction: Pelvic inflammatory disease (PID) is a group of infectious diseases of female upper genital tract. Chronic pelvic inflammation can lead to inflammation of fimbriae of the fallopian tube, leading to infertility. In very rare cases the fallopian tube can communicate with intestinal tract. Case Report: A 29-year-old Tibetan woman had a history of appendiceal perforation. She underwent salpingography for infertility and a recto-fallopian fistula was found, which was confirmed, during surgery, to be caused by chronic pelvic inflammation. Conclusion: Rectofallopian fistula is very rare and often secondary to chronic pelvic inflammation. Diagnosis depends on hysterosalpingography, colonoscopy, and other examinations, but the final diagnosis depends on surgery. It was found that surgery for recto-fallopian fistula should be performed as soon as possible. The main surgical methods are salpingoplasty and rectal mucosal repair. Laparoscopic surgery has been widely used in recent years.