BackgroundUterine septal defects have been linked to infertility and recurrent pregnancy loss. Hysteroscopic metroplasty is the procedure of choice for removal of such Mullerian anomalies. The long-term complications of operative hysteroscopy become more apparent as the number of such procedures increases.CaseA 26-year-old woman with a history of hysteroscopic resection of a uterine septum presented at term in active labor. Two hysteroscopic metroplasty procedures had been performed to remove the septum and uterine perforation occurred during the second procedure. In the subsequent pregnancy, uterine rupture occurred intrapartum, which lead to emergent Cesarean delivery and significant maternal morbidity.ConclusionUterine rupture may occur during labor, in pregnancies that follow hysteroscopic metroplasty.