Video Objective This video depicts a robotic assisted laparoscopic approach to hysterectomy in a patient with uterine didelphys and a longitudinal vaginal septum. Setting This is a 49 year old woman who presented with worsening abnormal uterine bleeding and dysmenorrhea, which was refractory to medical management. She desired definitive surgical management. This was performed as an ambulatory surgery within a hospital setting. Interventions Within the operating room, the uterine manipulator was only able to be placed in the left hemiuterus. The right hemiuterus subsequently lacked a colpotomy ring. The video itself demonstrates the resection of a rectovesical ligament, endometriosis resection off the left uterosacral ligament, ureterolysis, as well as bladder dissection off both cervices and vagina. A circumferential colpotomy is performed with only one colpotomy ring, and the longitudinal vaginal septum is resected robotically. The vaginal repair, distal uterosacral ligament suspension, and vaginal cuff closure complete the surgery. Conclusion Mullerian anomalies may require modifications to typical surgical procedure in performing hysterectomy. If present, the rectovesical ligament should be resected. With uterine didelphys, it may only be feasible to place one uterine manipulator. This critically leaves one cervix without a colpotomy cup. Begin colpotomy posteriorly and on the hemicervix with a colpotomy cup. The surgeon can then pull cephalad on the specimen while completing the colpotomy around the contralateral hemicervix. Ureteral awareness is critical while performing cuff suspension and closure due to the wide lateral colpotomy resulting from two cervices. The ureter is much closer in proximity and risks getting kinked. Consider ureterolysis and more extensive bladder dissection before cuff closure, and cystourethroscopy to ensure ureteral jets after closure.