ObjectiveUterine procidentia incarcerated by a vesicle calculi is a rarely encountered condition. The diagnosis and management is reviewed.Study DesignThe unique case of a 74-year-old woman with uterine procidentia incarcerated by a vesicle calculi is described. A medline search for all cases of incarcerated uterus was performed.ResultsA review of the literature revealed only 10 reported cases of uterine prolapse with incarceration. Our patient had an incarcerated uterus and anterior vaginal wall. Despite a total vaginal hysterectomy, the anterior vaginal wall remained irreducible. Cystoscopy confirmed an intravesicle bladder calculus. A vaginal cystotomy was performed to remove the stone.ConclusionVesicle calculi are the most common cause of irreducible prolapse and should be considered in all long-standing cases. Radiologic studies should be used to diagnose urinary calculi preoperatively. Vaginal cystotomy remains the surgical management of choice.