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Abstract Title: Clinical Challenges in the Management of Missing Intrauterine Devices: Two Case Reports. Background: Intrauterine devices (IUDs) are widely used for contraception due to their effectiveness and long-term benefits. However, complications such as displacement, expulsion, or migration can lead to cases of "missing" IUDs, posing diagnostic and management challenges for clinicians. Case Presentation: We report two cases of missing IUDs in women of reproductive age presenting with painful micturition and pelvic pain respectively. Case 1: A 35-year-old woman with a copper IUD inserted two years prior presented with painful micturition and haematuria.Pelvic examination failed to locate the IUD strings, and an ultrasound suggested migration in the urinary bladder. Cystoscopic removal was attempted but eventually the IUD was removed through suprapubic cystostomy. Case 2: A 40 year-old female with a history of hysterectomy 2 years back presented with chronic pelvic pain and discharge.Ultrasound imaging showed an IUD in the vaginally vault. Laparoscopic removal of IUD was performed successfully. Discussion: Missing IUDs may result from uterine perforation, expulsion, or migration into adjacent tissues. Diagnostic modalities such as ultrasonography, X-rays, and MRI are critical for localization. Management depends on the location and complications; minimally invasive techniques like laparoscopy and hysteroscopy are preferred. Conclusion: These cases highlight the importance of early detection and tailored management of missing IUDs to prevent complications. Regular follow-up and patient education are essential to improve outcomes in women using IUDs.