<p>Uterine rupture is a life-threatening obstetrical complication. Most cases of uterine rupture are associated with a trial of labor with previous cesarean delivery or having a history of myomectomy. Herein, we describe a 33 year-old female with a spontaneous uterine rupture at 28 + 4 weeks gestation age resulting in a demised fetus. Fetal bradycardia and an irregular protruding &ldquo;mass&rdquo; over the left upper abdomen with no fetus in a boggy uterus were identified by sonography. An emergent cesarean section was performed and on entering the peritoneal cavity, a complete expulsion of the fetus and placenta from the uterine cavity was noted. A flaccid fetus without heartbeat with a large uterine ruptured scar extending from the left lower segment to left lateral wall were found. A right unicornuate uterus was confirmed later by hysterosalpingography and MRI. Spontaneous uterine rupture should be listed in the differential diagnosis of an acute abdomen during pregnancy.</p> <p>&nbsp;</p>