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ABSTRACT CASE REPORT A 29-year-old female, multigravida came with chief complaints of fever from last 5 days with abdominal distention following an emergency caesarean section done 7 days back. The baby was IUD. On examination uterus was about 18 to 20 weeks gravid uterus size with foul smelling lochia. Ultrasound revealed hepatosplenomegaly, cholelithiasis and gall bladder sludge, with bilateral pleural effusion, bulky uterus with endometritis, scar dehiscence. USG guided aspiration was done where purulent fluid was drained and sent for culture sensitivity where MRCONS (methicillin resistant coagulase negative staphylococci) were isolated. The patient underwent subtotal hysterectomy, there were pus filled pockets seen intraoperatively sent for culture sensitivity where klebsiella species were isolated. Pus was sent for AFB and CBNAAT which came out to be negative. Final histopathological examination of uterus and cervix showed endometritis with scar dehiscence. Further postop surveillance was continued. DISCUSSION Puerperal Sepsis remains one of the foremost causes of preventable maternal death worldwide even decades after the advent of effective low-cost novel antimicrobials. In developing countries like India, where the paramount impediment to intervention is poverty, maternal mortality due to sepsis is a continuing representation of maternal health inequality. Puerperal sepsis is an important cause of postpartum morbidity and mortality. The surgeon is left with a difficult dilemma: remove the infection source (uterus) to preserve the life of the patient at the cost of her fertility, or preserve the uterus and fertility but risk worsening infection and possible death for the patient.