Introduction <p>Uterine Rupture is one of the most catastrophic events in obstetrics. Poor antenatal care, obstructed labor and previously scarred uterus are the preceding factors. Signs and symptoms are not specified but high rate of suspicion in predisposed patients is key to, decrease the mortality and morbidity.</p> Aims and Objectives <p>The objective of study was to know the incidence, etiology, choice of surgical management, and outcome in patients of rupture uterus.</p> Material and methods <p>It is an institution-based retrospective study carried out at the Department of obstetrics and gynecology, Shyam Shah Medical College, Rewa (M.P). All the diagnosed rupture uterus patients admitted from Jan 2016 to Dec 2020 were included in the study. Approval from Institutional ethical committee was taken. Data regarding clinical, investigational, and management details were retrieved from the case records of 80 women with diagnosis of uterine Rupture.</p> Results <p>Majority of women (92.5%) were referred from peripheral health care facilities as an obstructed labor or rupture uterus. Mean age of presentation was 27 years. Common clinical presentation was palpation of superficial fetal parts, vaginal bleeding (53.75%). Previous scar was commonest cause of rupture uterus followed by anterior lower segment (37.5%) rupture in unscarred uterus. All the patients were subjected to laparotomy. Surgical management included rent repair (65%), subtotal hysterectomy (20%), and total abdominal hysterectomy (5%). Majority of the patients had labor started at home. There was high rate of perinatal mortality (95%) and maternal mortality of 3.75%.</p> Conclusion <p>Effective management of uterine rupture reduces maternal and fetal morbidity and mortality. Grading of uterine rupture will be helpful for obstetrician to take decision regarding patient management.</p>