<p>Vesicouterine fistula is an abnormal communication between the bladder and uterus, usually following lower segment cesarean section. Youssef’s syndrome remains a rare entity with classical symptoms of menouria acting as a clinical pointer towards the diagnosis. Imaging acts as a very useful tool for timely diagnosis and management. We report such a case of a 22-year-old lady, with large vesicouterine fistula identified on imaging with cytoscopic correlation in a case where the patient presented with menouria, absence of vaginal bleeding, and history of multiple episodes of urinary tract infection in a brief period of 2&#xa0;months post lower-segment cesarean section. This case is unique in the way it was diagnosed early (within 2&#xa0;months of symptom onset) followed by adequate imaging including timely MRI and cystoscopy that resulted in early identification and timely surgical intervention in the form of an excision of the fistulous tract with omental flap interposition. Early clinical suspicion supported by detailed history, followed by adequate examination and imaging, is necessary for timely diagnosis and intervention in such cases which have a very variable and rather delayed presentation in most scenarios. MRI is the imaging modality of choice for both diagnosis and treatment planning followed by cystoscopy which remains gold standard.</p>