Disruption of a prior uterine incision scar after using misoprostol in term pregnancies has been well docu mented [1,2]. Nevertheless, second-trimester termina tion using misoprostol may result in rupture in an unscarred uterus [3]. This complication is extremely rare and can be life-threatening and lethal if not well managed. Herein, we report a case of uterine rupture after using misoprostol for second-trimester termina tion, with no previous uterine surgery. The patient was diagnosed in time and underwent emergency operation. She recovered well 6 days after operation and was then discharged in good condition. A healthy 32-year-old woman was admitted to a local clinic for termination at 21 weeks ofgestation because of intrauterine fetal demise. Her obstetric history con sisted of two spontaneous vaginal deliveries and one ectopic pregnancy, which was treated by right salpin gectomy. Besides, she had no other medical or surgical history, including no uterine incision or cervical surgery, and did not take any medication before admission. After admission at the local clinic, she was given rni soprostol 150 ~g intra-rectally. Twenty-four hours later, an additional dose of misoprostol 100 ~g was given orally. After taking the oral misoprostol, she suffered an acute, sudden and persistent lower abdominal pain, with profuse bloody show followed by hypovolemic shock. She was transferred to our hospital for emergency treatment. At the emergency service, pelvic examination revealed a distended abdomen with board-like abdomi nal muscle guarding and pelvic pain with lifting. Ultra sonography revealed a dead singleton fetus in breech presentation and partial placenta previa. In addition,