Uterine rupture during pregnancy, while quite rare, can have devastating consequences for both mother and fetus if it does occur. Uterine surgery is recognized risk factor for uterine rupture during pregnancy. Presently, adenomyomectomy is performed not infrequently as a treatment for infer tility. However, the potential adverse outcomes associated with this procedure have not been extensively investigated. We report a case of spontaneous uterine rupture at 22 weeks of gestation following adenomyomectomy, leading to a stillbirth and maternal hypovolemic shock due to severe hemorrhage. If a pregnant woman with a history of uterine surgery presents with sudden abdominal pain, uterine rupture must be considered as a differential diagnosis. Given that spontaneous uterine rupture after adenomyomectomy can occur in the second trimester of pregnancy, it is crucial for patients with adenomyosis desiring to conceive to carefully consider the implications and risk of undergoing adenomyomectomy.