Chronic nonpuerperal uterine inversion is an extremely rare clinical situation. We report a 36 year-old woman with chronic nonpuerperal uterine inversion due to a fundal leiomyoma. She was treated with laparotomy assisted vaginal hysterectomy. We emphasized the impor-tance of abdominal access at the time of vaginal hysterectomy for complete inversion ofuterus. After excluding possible bowel loops in the inverted uterus through abdominal inci-sion, vaginal subtotal hysterectomy was performed followed by total hysterectomy. In addi-tion to better surgical exposure, abdominal approach also helped management hemorrhage as in our case.