Purpose <p>Non-puerperal uterine inversion is a rare and life-threatening condition. Diagnosis can be challenging, and the optimal treatment is uncertain.</p> Methods <p>Records of the case were retrieved from electronic medical records, and telephonic follow-up was done to determine her current status.</p> Results <p>A 16-year-old nulliparous female presented to the emergency room with heavy vaginal bleeding. The MRI findings revealed uterine inversion, which was confirmed and managed surgically. Uterus was repositioned using the Haultain procedure. Histopathology of the tissue showed a low-grade uterine adenosarcoma. The patient opted for fertility preservation instead of the recommended hysterectomy due to her young age. She did not receive chemotherapy and was planned for a careful follow-up visit. Subsequently, the patient declined follow-up appointments, leading to a delayed diagnosis of metastasis 18&#xa0;months later. By the time of diagnosis, the tumor had invaded the uterus, rectum, and presacral region.</p> Conclusion <p>Adenosarcoma-induced uterine inversion is an exceedingly scarce and rarely reported clinical condition. Given the high probability of tumor recurrence, the preferred plan is a hysterectomy with careful monitoring of the patient after surgery. This case highlights the potential risks of fertility preservation without adjuvant therapy. Its supports early surgical removal of the uterus and ovaries even in young patients with uterine inversion due to adenosarcoma. We performed a literature review on the prevalence of different etiologies of uterine inversion documented in the last 15&#xa0;years on PubMed. Our search revealed 277 uterine inversion cases. The most common cause of uterine inversion in puerperal cases was postpartum complications (27%). In non-puerperal cases, fibroids were identified as the predominant cause (19%).</p>