Background: Situs inversus totalis, also known as dextrocardia with situs inversus, is a rare congenital condition characterized by complete mirror image reversal of normal positioning of thoracic & abdominal organs. While individuals are often asymptomatic, its association with female infertility is uncommon and sparsely reported. Recognition of this condition is important during infertility evaluation to avoid diagnostic and procedural challenges. Case Presentation: We report the case of a woman presenting with primary infertility who was incidentally diagnosed with Dextrocardia & Situs inversus during routine clinical and imaging evaluation. The patient had regular menstrual cycles and no significant past medical history. A chest X-ray, transabdominal & transvaginal ultrasonography revealed complete situs inversus, with a right-sided cardiac apex and transposition of abdominal organs. Detailed gynecological evaluation showed normal uterine morphology and ovarian reserve parameters. Further infertility work-up did not reveal additional contributory factors. The patient was counseled about the condition and its implications for reproductive management. Discussion: Recognition of dextrocardia with situs inversus is essential for accurate interpretation of imaging findings and appropriate planning of diagnostic and therapeutic procedures. Awareness of reversed anatomy is particularly important for safe surgical interventions and assisted reproductive techniques when needed. Conclusion: This case highlights the importance of considering rare congenital anomalies like dextrocardia with situs inversus during infertility evaluation. Early identification allows individualized counseling and tailored reproductive management, thereby improving fertility outcomes.