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PurposeBicorporeal uterus has a prevalence of 0.3% and can have significant implications in pregnancy. We encountered a patient in her third pregnancy with a bicorporeal uterus, having had two previous caesarean sections. This pregnancy was in the left hemi-uteri which was damaged during her previous delivery. We discuss the antenatal and intraoperative considerations undertaken. We also share her antenatal imaging and intraoperative photos of her pelvic anatomy.MethodsA comprehensive literature search was undertaken on PubMed revealing that uterine torsion in the context of a bicorporeal uterus in pregnancy is a rarely documented occurrence. We used the patient’s electronic obstetric notes for all her pregnancies as well as the computerised records of her imaging. Her caesarean section was electively planned and led by two experienced obstetric consultants and a senior registrar. Postnatally she was contacted for permission to publish the images from her scans and caesarean section. ResultsHer previous obstetric history was important and allowed a high index of suspicion for obstetric complications. Prediction of surgical complexities on antenatal screening and imaging was important in her case. Finally anticipation of possible intraoperative complications allowed for pre-operative planning. ConclusionThis case encompassing a series of learning points and surgical tips which has educational value as well as clinical interest. In the presence of a uterine abnormality, placental complications, extensions of incisions and vascular injury should be anticipated. A safe incision site must be identified before entering the uterine cavity. Therefore involvement of senior clinicians is essential.