Unicornuate uterus with rudimentary horn is a mullerian duct malformation with incidence of 5- 10% of all uterine malformations. We discuss a case of 30 year old nulliparous patient, with chronic pelvic pain and dysmenorrhoea worsened over the past few months with future fertility concerns.USG showed a unicornuate uterus with a left sided uterine horn with an endometrial cavity; findings were confirmed by MRI. Patient underwent hysteroscopy with metroplasty & laparoscopic resection of rudimentary horn. Hysteroscopic metroplasty helped to increase the size of the small cavity of the uterus and plan conception. She conceived after 6 months and delivered a healthy baby vaginally. Excision of the rudimentary horn in most cases is similar to that of hysterectomy. Separation of the horn from the uterus is easy when there is merely a band of fibrous tissue between them. It becomes more complex when the horn is closely attached to the uterus. The gold standard for diagnosing Mullerian anomalies is hysteroscopy and laparoscopy.
