Although spontaneous uterine rupture is rare,1 its occurrence frequently results in death or damage to the fetus. Most of the few case reports of rupture following operative hysteroscopy2 are related to hysteroscopic metroplasty, with or without perforation. 3 Use of simultaneous laparoscopy or ultrasound may assist surgeons in preventing perforation. Patients considering pregnancy after hysteroscopic metroplasty with perforation should be advised of potential uterine rupture.2