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Uterine rupture is a potentially catastrophic complication of caesarean section. Atypical rupture occurring away from the previous scar site is extremely rare with less than 20 cases reported in the literature. A 38-yearold presented at 37 weeks gestation with maternal collapse. Emergency caesarean section revealed foetal loss and a posterior uterine rupture with an intact lower uterine segment. A subtotal hysterectomy was performed. Disseminated intravascular coagulopathy (DIC) developed rapidly and required massive transfusion. The patient was discharged home twelve days later. Posterior uterine rupture is rare and requires prompt surgical intervention and multi-disciplinary teamwork to prevent serious maternal morbidity.