Though unicornuate uterus with rudimentary horn is a rare Mullerian duct malformation, it is marked with frequent undesired gynaecological and obstetrical complications. Rupture of gravid horn results in maternal and foetal morbidity and mortality. A case of rudimentary horn pregnancy at 15 ± 4 weeks was reported here, with acute renal failure in the postoperative period. The favorable maternal outcome was only ensured after extensive hemodialysis sessions apart from appropriate intensive care management.