Abstract
Hysterectomy is one of the most common gynecologic procedures performed worldwide. Vaginal cuff dehiscence with resultant bowel evisceration, while rare, is one of the most serious complications of the procedure. We present the case of a 79-year-old female with vaginal cuff dehiscence several decades after hysterectomy. The patient had no significant antecedent symptoms until she experienced bowel evisceration during Valsalva. She underwent a successful reduction of bowel contents with limited resection and transvaginal cuff repair. This case highlights the risk of vaginal cuff dehiscence even decades following the procedure.