A life threatening complication of intrauterine procedure (Dilatation and curettage)is uterine perforation besides having medico legal implications. Since medical abortion has been legalized, it has become very rare during the D&C procedure in recent times. Early diagnosis is key to survival, especially if an unsafe abortion has been performed. Therefore, if the patient has lower abdominal pain, and the history of surgical abortion may be unknown most of the time, a high index of suspicion should be maintained. This case report emphasizes an atypical presentation of uterine perforation in a 28 year old woman with H/o Caesarean section 1 year back, who underwent D&C procedure at 19 weeks of pregnancy. She was discharged after the surgery, assuming there were no complications. Two days after the procedure, patient presented with complaints of acute abdominal pain and distension associated with features of internal bleeding and Bowel obstruction. Trans abdominal Ultrasound was performed, uterine perforation with Massive Haemoperitoneum was diagnosed. X ray abdomen erect view confirmed Bowel obstruction. Intra operatively, foul smelling haemoperitoneum was drained, Fetal parts were removed from Pouch of Doughlas and abdominal cavity, Postero lateral wall of uterus was perforated of size 3cm×3cm with Gangrenous changes and Emergency Laparotomy was proceeded to Hysterectomy with Bilateral salphingo- oophorectomy and Adhesiolysis. Prompt recovery was achieved after surgical intervention. This case report highlights the importance of increased awareness during the D&C procedure. Furthermore, it also emphasizes the importance of pre-operative counselling and post-operative monitoring to ensure early detection and prompt management of life-threatening complications.