A rare case of acute non puerperal complete uterine inversion in nulliparous virgin female

Non-puerperal uterine inversion (NPUI) is extremely rare and accounts for 17% of all cases. A few more than 150 cases have been reported amongst which 10-15 in nulliparous females 3-4 virgin from 1914 till date. 40 years unmarried female denying sexual activity presented to our hospital with acute non puerperal complete something coming out per vaginum sudden onset while straining at defecation, lower abdominal pain minimal bleeding history fibroid chronic constipation. Diagnosis was confirmed ultrasonography examination under anaesthesia after written informed valid consent. After detailed counselling obtaining consent, the patient underwent exploration a combined abdominal-vaginal approach. Following vaginal myomectomy, uterus repositioned using Haultain procedure failed attempt Huntington procedure. Total hysterectomy bilateral salpingectomy vault suspension done sparing ovaries. requires high index suspicion their management challenge gynaecologists due its occurrence, distorted pelvic anatomy associated organ injuries during surgery. Good anatomical clinical knowledge along surgical skills utmost importance successful outcomes.