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Background: Acute uterine inversion is a rare, but serious, obstetric complication in the third stage of labour, commonly resulting in significant morbidity and mortality. A total or partial invagination of the uterine fundus occurs, followed by profuse bleeding and circulatory instability. The case presented here illustrates a typical clinical course of the condition.

Case Presentation: After giving birth to a large, healthy boy, a woman developed acute uterine inversion. The uterus was successfully repositioned using Johnson's manoeuvre under general anaesthesia, and significant transfusion was needed to combat the resulting haemorrhage.

Interpretation: Acute inversion of the uterus should be suspected based on purely clinical signs. Treatment should commence without delay by a multidisciplinary team of obstetricians, anaesthesiologists and surgeons.