Background/Aim: Vesico-uterine fistulas represent a rare type of genito-urinary fistulas; however, due to the increasing incidence of Caesarean section (C-section) in the last decade, this abnormal communication between the urinary and genital tracts has been reported more often after such surgical procedures. The aim of the current article was to report the case of a 28-year-old patient who was submitted to surgery for a vesico-uterine fistula seven years after a C-section. Case Report: The 28-year-old patient with a previous history of four vaginal deliveries and one C-section was self-presented to the Gynecology Department for cyclic hematuria and diagnosed with a vesico-uterine fistula after injecting methylene blue in the uterine cavity during hysteroscopy. The patient was further submitted to surgery, and a parcelar myometrectomy en bloc with parcelar cystectomy, cystography, and prophylactic salpingectomy was performed. The postoperative outcome was uneventful. Conclusion: Although vesico-uterine fistulas represent rare events, they should be considered, especially in young patients with a previous history of C-section.Abnormal communications between the urinary and gynecological tracts are usually encountered in cases presenting locally advanced uro-gynecological malignancies such as cervical cancer (1). In addition, such abnormal communications are encountered after previous irradiation for pelvic malignancies and are most often located between the urinary bladder and vagina (2, 3). However, in other population subgroups, the most frequently encountered fistulas are vesico-uterine fistulas, especially in younger women with previous history of pelvic surgical procedures (4-7). Therefore, it is estimated that less than 5% of all urogenital fistulas are represented by vesico-uterine fistulas; however, due to the increasing incidence of surgical procedures at the level of the pelvic area among young patients, especially due to the increasing number of Csections, the number of vesico-uterine fistulas has reported an ascendant trend. In this respect, it should be noted that up to 88% of all these abnormal communications are related to C-sections (7, 8). The aim of the current paper was to report the case of a 28-year-old patient with a previous history of four vaginal births and one C-section, who was diagnosed with a vesico-uterine fistula seven years after the C-section.