Background: Utero-cutaneous fistula (UCF) is an ex-tremely rare entity and only a few case reports have been published. Most UCFs develop secondary to post-partum or postoperative complications.Case Report: A 42 year-old woman began to com-plain from bleeding and malodorous discharge through her abdominal incision scar. The fistula tract with a thickness of 8 mm was observed between the uterus and wound using magnetic resonance imaging (MRI). The risks and benefits of conservative treatment have been discussed; the patient demanded definitive treat-ment, so hysterectomy and excision of the fistulous tract was performed. Histopathology of the fistulous tract showed endometrial epithelization of the tract lined by granulation.Conclusion: There are many causes of such an ex-tremely rare entity. Patients should be counseled for medical or surgical treatment considering their age, accompanied uterine pathologies such as fibroids and fertility expectations