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Introduction : Vesiclo uterine fistula is the least common type of urogenital fistula accounting for 1-4 % of urogenital fistula. It is having increasing frequency following increasing rate of caesarean sections. AIMS: To study the case report of a patient with vesico uterine fistula following caesarean section who underwent diagnostic cystoscopy and hysteroscopy with Laprotomy and Vesico uterine fistula repair. Case report: A patient, Mrs. X, aged 26 yrs, P2L2 following Emergency LSCS (Indication ? obstructed labour) 3 months back, came with complaints of urinary incontinence since 3 months. She has undergone LSCS 3 months back following prolonged labour with IUD at Taluk Government hospital. Cystoscopy was done to identify fistula, the patient was catheterised for 3 months for conservative management of fistula . Diagnostic cystoscopy and hysteroscopy with Laprotomy and Vesico uterine fistula repair was done. On Cystosopy Fistula was seen above and medial to right VUJ, Guide wire was passed into the fistulous opening. Hysteroscopy was done and guide wire was noticed entering from the anterior wall of the uterus in the lower segment. Midline infraumbilical laparotomy was done, infraumbilical laparotomy incision taken and abdomen was opened in layers. By sharp dissection bladder was separated from the uterus. Fistulous tract identified between the posterior bladder wall and anterior uterine wall in the lower segment. Fistulous tract excised. Bladder edges were freshened and 16Fr SPC placed. Bladder was closed with vicryl 3-0 in 2 layers, uterus was closed with vicryl 2-0 in 2 layers. Omentum interposed between bladder and uterus. Intra abdominal drain no 24 was placed patient with stood the procedure well. Conclusion : Vesico uterine fistulas represent a rare type of genitourinary complication.However in the last decade with increasing number of caesarean sections and thereby the complications associated with it, increasing trend has been reported. In case of small fistulae identified post partum free drainage and antibiotic coverage may result is spontaneous closure. However in large fistula surgical closure is required.