A rare case of uterine sacculation is reported. This case illustrates the difficulties in arriving at a diagnosis of uterine sacculation due to the obscure clinical presentation. The initial working diagnosis in this young nulliparous woman was intra-uterine foetal death but after a failed induction the diagnosis was re-evaluated. The correct diagnosis was only made at laparotomy. A total abdominal hysterectomy was performed because of incarcerated and gangrenous uterus. Management options are also discussed.